8/16/2019 RMA_29MEI2015_ex

1/1

Return Authorization Form

Honeywell Security BusinessFlat A, 16th Fl., CDW Building, 388 Castle ea! "oad, #suen Wan, Hong

$ong.Tel: (852) 2405 2323 Fax: (852) 2415 3112

Customer InformationCompany Name :

PT AXINDO H !AP"#DANACon$a%$ Pe&'on : "ma l :

Tel :Fax :

Customer uses Plea'e p&o *e $+e ,ollo- n. n,o&ma$ on (all n,o&ma$ on ' &e/ &e* $o p&o%e'' a #!A &e/ e'$) Office uses

I$em !o*el No P&o lem e& al NoDa$e %o*e

In o %e No

a&&an$y(6e' No)

#e' l$ #e%ommen*a$ on' #!A

1 HIDC72300 PO" O,, 12051085212

PO" O,,

Return Procedure :

1) 9e,o&e %all n. ,o& an #!A n m e& plea'e ma;e ' &e $+a$ yo +a e %o&&e%$ly ,ollo-e* $+e n'$alla$ on n'$& %$ on' an* ope&a$ n. p&o%e* &e' ,o& $+e p&o* %$' $+a$ a&e lo%a$e* n $+e 'e&) No &e$ &n a%%ep$e* - $+o $ an #!A n m e& a 'ol $ely no ex%ep$ on'

Office uses

#e%e e* y :

Da$e :

#e%e e* y :

Da$e :

C+e%; y :

Da$e :

App&o e* y :

Da$e :

#e%e e* y :

Da$e :( a&e+o 'e Depa&$men$) (Te%+n %al Depa&$men$) (C '$ome& 'e& %e)

RMA NO. Date

2? !e 2015