Trouble report – Service request

Please read through the terms, complete the form and indicate the type of service your order requests.

Is the product covered by the limited warranty: No Use SEND-IN or PICK UP service.

Yes Use SWAP / PICK UP or SEND-IN service.

Is the product covered by a valid extended warranty contract: No Yes Contract No.:

SWAP:
Please send the form to EIZO.
Eizo Europe AB delivers the SWAP product to the SWAP address as below. The trouble reported product should be packed in the received SWAP product box and available at the SWAP address. Eizo Europe will arrange Pick Up for the trouble reported product. / Pick Up:
Please send the form to EIZO.
Eizo Europe AB will arrange Pick Up at the Pick Up address as below. The trouble reported product should be packed in the original box and available at the Pick Up address. / SEND-IN:
Please send the trouble reported product include this form to EIZO.
Trouble reported product should be packed in its original box or in an equally sufficient transportation box and be returned to Eizo Europe AB. The sender is responsible for the transport insurance.

As reference, always mention (see the front and/or the back of the product):

Model (FlexScan/ColorEdge/RadiForce…)
/ Serial number (S/N:)
/ Color of chassis

Request by person/Sender (invoice address) SWAP/Pick Up/Return address (if other then the senders)

Company / Company
Contact person/Department / Contact person/Department
Street address / PO Box / Street address / PO Box
Postal code / City / Postal code / City
Country / Country
Organization number / Cell/Mobile / Business hours / Cell/Mobile
Telephone / Fax / Telephone / Fax
E-mail / E-mail

Fault descriptions (please tick problem type or describe symptoms)

IMAGE / Fuzzy / Unstable / Geometrical error / Color error / Config error / Pixel error
NO IMAGE / Indicator led Green Yellow Flashing Off / DOA (Defect On Arrival)
DAMAGED / Transport damage / Damage by lightning / Theft marked / OTHER damage or defect as below
Detailed fault description:
Error visible in (fV) Hz, (fH) kHz, 640x480 800x600 1024x768 1280x1024 1600x1200
Other resolution x Problems appear: -constantly -sometimes -how often:
Warranty No warranty Service pricing, see: www.eizo.se or phone Eizo Europe AB, Tel.: +46-8-590 80 000

Eizo Europe AB reserves the right to charge:

·  If the trouble reported product has flaws, defects, damages, etc. that are not covered under warranty.

·  For work expenses upon troubleshooting and for freight costs if trouble reported product should prove to be free of defects.

·  For the replacement product if the trouble-reported product does not arrive at Eizo Europe AB within 10 days of delivery of the replacement product. Return of the trouble-reported product after more than 10 days of invoice date is not accepted.

I accept the above terms and order above service for the trouble reported product.

Date: / Name / Sign:
EIZO’s notes: Information about the SWAP product: / SO-Number:
Model: …………………..….……. S/N: ….………….……….……… Datum / Signature:

Eizo Europe AB, Service department Telephone: +46 (0)8 - 590 80 000 Office hours:
Lövängsvägen 14 Fax: +46 (0)8 - 590 915 75 Monday – Friday: 8.30 – 17.00
SE-194 45 UPPLANDS VÄSBY E-mail: Lunch break: 12.00 – 13.00
SWEDEN