SERVICE FORM

company name:

country:

contact person:

name:

first name:

e-mail:

telephone:

Theysohn invoice no.:

plant component:

extruder
screws&barrels
tooling
calibration
haul-off/saw/etc.

order no. / serial no. / comm. no.


(see label, delivery note, invoice or extruder control page 100)

error category:

mechanical
electrical
on the product

detailed description of the malfunction:


(please use part identification from delivery note, list of items or user manual)