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NOTA DE CONSTATARE

Denumire pies

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Cod pies

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Marca / tip auto

___________________________________

Tip motor _________________________________

Nr. nmatriculare

___________________________________

An fabricaie _______________________________

n data de __________________________________________, kilometraj ____________________________, la autovehiculul

sus numit conform devizului de montaj nr._________________________________________________________s-au efectuat
urmtoarele operaii: ___________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
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Prelucrri mecanice conexe_______________________________________________________________________________
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n data de __________________________________________, kilometraj _______________________________autovehiculul
sus numit s-a prezentat n unitatea noastr cu urmtoarea reclamaie de garanie:
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
Dup demontarea / analiza piesei am constatat urmtoarele: ____________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
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Prerea noastr este: ___________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
Solicitm: _____________________________________________________________________________________________
_____________________________________________________________________________________________________
Data:

Persoana care a efectuat constatarea:

tampila unitii:

Nume:

__________________________________

Numar telefon:

__________________________________

Semntura:

__________________________________

* Se completeaz obligatoriu toate cmpurile!