| Vorgangsnummer |
|
| Vorname | ______________________________________________________ |
| Nachname | ______________________________________________________ |
| Straße/Hausnummer | ______________________________________________________ |
| PLZ/Ort | ______________________________________________________ |
| Telefon-Nummer(n) | ______________________________________________________ |
| eMail-Adresse | ______________________________________________________ |
| beste Erreichbarkeit | ______________________________________________________ |
| Gerätefabrikat | ______________________________________________________ |
| Geräteart |
Radio
Fernseher
Verstärker
sonstiges |
| Gerätetyp | ______________________________________________________ |
| Zubehör | ______________________________________________________ |
| Genaue Fehlerbeschreibungen |
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| bereits ausgeführte Arbeiten |
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