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  • Rma 0001582661 20231206 111558

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    dsargoarnowo
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    This document provides information for the return of goods (equipment/instrument/sample) with Return Material Authorization (RMA) number 1582661. It summarizes that a completed Safety Declaration for Returned Goods form must be included for any item sent back to Anton Paar. If the form is not provided, Anton Paar will email the customer within a week of receipt to complete it, otherwise the goods will be returned at the customer's expense. It also records customer and item details for a Field Replacement Kit being returned.

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    RMA_0001582661_20231206_111558

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    This document provides information for the return of goods (equipment/instrument/sample) with Return Material Authorization (RMA) number 1582661. It summarizes that a completed Safety Declaration for Returned Goods form must be included for any item sent back to Anton Paar. If the form is not provided, Anton Paar will email the customer within a week of receipt to complete it, otherwise the goods will be returned at the customer's expense. It also records customer and item details for a Field Replacement Kit being returned.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    11 views2 pages

    Rma 0001582661 20231206 111558

    Uploaded by

    dsargoarnowo
    This document provides information for the return of goods (equipment/instrument/sample) with Return Material Authorization (RMA) number 1582661. It summarizes that a completed Safety Declaration for Returned Goods form must be included for any item sent back to Anton Paar. If the form is not provided, Anton Paar will email the customer within a week of receipt to complete it, otherwise the goods will be returned at the customer's expense. It also records customer and item details for a Field Replacement Kit being returned.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 2

    SDRG

    RMA number: 1582661

    Note: Due to employee safety regulations the fully completed form and all relevant SDRG documents for each
    equipment/instrument/sample sent to Anton Paar must be attached. If no “Safety Declaration for Returned Goods" was
    attached, Anton Paar will e-mail you the form to complete within 1 week of arrival of the goods. If Anton Paar does not
    receive the data within this time, the goods will be returned at your expense.

    End-Customer Data

    Company: Address:
    PT. EQUIVA LIGAND INDONESIA PT. Equiva Ligand Indonesia
    TIFA Building 2nd Floor, Suite 206
    Department: JI Kuningan Barat No. 26
    Mampang Prapatan
    Service 12710 JAKARTA SELATAN
    INDONESIA
    Person Responsible: Phone:
    Mr. Dwi Sandi Argo Arnowo +62215220252

    Email: Fax:
    dwisandi@equivaligand.com

    Sent Goods Repair / Maintenance Return Sample

    Equipment/Instrument/Sample Data

    Mat. No. Instrument Serial Number Qual. Pharma Equ.* Software Version* PC

    212678 FIELD REPLACEMENT KIT, 10 INCH MANTLE P140


    Additional Information:

    *Please complete data, if applicable


    Equipment / Instrument was not used
    Equipment was decontaminated before shipment (outer surface and internal parts)

    Name of Sample or Cleaning agent None

    None GHS01 GHS02 GHS03 GHS04 GHS09 GHS05 GHS06 GHS07 GHS08 Radio-
    active

    Customer Declaration
    I confirm that the information entered above is complete and correct. For the customer:

    DWI SANDI ARGO ARNOWO 13.12.2023


    (Signature) (Name in block letters) (Date)
    Attention: During maintenance or repair we may need to reset your instrument which will lead to data loss. Please ensure to back up your data before
    shipping the equipment to us. If you need guidance on how to do this, please do not hesitate to reach out to our service team who will be more than happy
    to assist you.

    Please cut the paper here and attach the RMA-label on the outside of the box resp. add it to the delivery documents.

    Return Material Authorization No. 1582661

    Please ship to the following address:

    Anton Paar QuantaTec Inc.


    1900 Corporate Dr
    BOYNTON BEACH FL 33426-6650
    UNITED STATES OF AMERICA

    RMA issued by: Mr. Don Merrill


    Phone: +15617314999
    Email: donald.merrill@anton-paar.com

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