Post Units01-03, 10/F, Prosperity Place, 6 Shing Yip Street, Kwun Tong, Kln., H.K. OR

CTS210-2 (05.2010)

Date / ：
Repairs Application Form
Customer No. / ： / Name / ：
Contact Person / ： / Tel. / ：
Address / ：
Appointment Date / ： / Time / ：
Please fill in the followings
Date of system Installation / ： / YY / MM / DD
Maintenance plan effective date(If any) / ： / YY / MM / DD
Previous cartridge replacement date / ： / YY / MM / DD
Maintenance period up to / ： / YY / MM / DD
Repair item(s) / Please write down the model number in the space provided
System
Cartridge
Faucet
Indoor Water Dispenser
Stainless Steel Water Dispenser
Drinking Fountain
Water Boiler
Details of repair / Please mark ”X” in the space provided
leaking / Leaking at / (please specify)
Flowing slow
No water out
No hot water
No cold water
Black water
Peculiar taste
Turbid
Milky color water
Others / (please specify)

Please fill in the maintenance form and send out by

Post：Units01-03, 10/F, Prosperity Place, 6 Shing Yip Street, Kwun Tong, Kln., H.K. OR

Fax：2380 8740 OR

E-Mail：

to Richform Holdings Limited.