Address of sender (Company/Street/Post Code/Town)

Jetter AG

Graeterstr. 2

71642 Ludwigsburg (Germany)

Attn: Andrea Ifländer	Contact:

Phone +49 7141/2550-509	Phone:

Fax +49 7141/2550-425	Fax:

E-mail: return@jetter.de	E-mail:

End customer's contact person (if known):

Returns Form

Dear Business Partner,

You have acquired a high quality product from Jetter AG. Should you for any reason need to return it to us, please be so kind as to use this returns form following the procedure below. A detailed problem report helps us with the analysis and speeds up the problem solving process.

We suggest you keep the returns form for future reference.

Should more than one item with different problems be returned, please copy this form and use one copy for each item.

Complete the form fully and return it with the goods.

Use, where possible, the original packaging. For PCBs always use anti-static packaging material.

Returned items:

Item	Serial number	Delivery note number

Why are you returning the goods? (please tick appropriate box)

Incorrectly ordered
Incorrect delivery
Transport damage
Retrofit/upgrade
Functional test
The device does not work, yet I could not find out the cause of defect Repair at own cost Repair under warranty
Reason:
Old device for disposal

Transport damage must be reported to us and the forwarder within 24 hours of receipt of goods.

Leave the goods as received in the original packaging for inspection. Please take photos of the damaged package/goods.

Please turn over

Description of defect

When does the defect occur?

Intermittently	Frequency:
Permanently	Frequency:
After a certain period
On power-up
When did the defect originally show up?

Description of the defect:

Does the defect show up at a certain temperature?	Yes No
What does the display show? (please submit a photo or video)
Is communication with the device possible?	Yes No
Place of installation (country, shop floor, lab, machine before its delivery to the end customer, field) and environmental conditions?
Place of installation in the machine and function of the device (line, section, axis/function)
Loads (impact, temperature and humidity changes)?
Have software updates and downgrades been made? When/what:	Yes No
Did the defect show up in connection with a software change?	Yes No
Operating voltage?
Who exchanged the device (field engineer, customer)?
Which LEDs are active/which error codes are displayed in case of a defect? (please submit photo)
Did the line-side circuit-breaker trip?	Yes No
Did you save your program and your data registers?	Yes No
Please describe the defect in as much detail as possible:

Date: _________________	Signature (company stamp):________________________________

Additional information: