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Date: / / , P-1 / ,
TO: NEC Display Solutions' Authorized Service Station:
FM:
(Company & Name with signature)
Dear Sir (s),
I would like to apply your TravelCare Service Program and agree with your following
conditions, and also the Service fee will be charged to my credit card account, if I don't
return the Loan units within the specified period. I also confirm the following information
is correct.
Regards.
Application Sheet for TravelCare Service Program
Country,
product purchased:
User's Company Name:
User's Company Address:
Phone No., Fax No.:
User's Name:
User's Address:
Phone No., Fax No.:
Local Contact office:
Local Contact office Address:
Phone No., Fax No.:
User's Model Name:
Date of Purchase:
Serial No. on cabinet:
Problem of units per User:
Required Service: (1) Repair and Return
(2) Loan unit
Requested period of Loan unit:
Payment method: (1) Credit Card (2) Travelers Cheque (3) Cash
In Case of Credit Card:
Card No. w/Valid Date: