SN (view type plate):
Warranty / Guarantee
Date of delivery:
Delivery note no.:
Model designation:
Stamp of the specialist dealer:
Serial-no.(SN):
Delivery note no.:
Model:
Stamp of specialist dealer:
Next safety inspection in 12 months
Date:
Place, date:
Signature:
63
Warrantee / Guarantee section
Please fill out! Copy if necessary and send the copy to the specialist dealer.
Inspection certificate for transfer
Electric wheelchair data: