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NOTA DE CONSTATARE

Denumire piesă _______________________________________________________________________________

Cod piesă ___________________________________

Marca / tip auto ___________________________________ Tip motor _________________________________

Nr. înmatriculare ___________________________________ An fabricaţie _______________________________

În data de __________________________________________, kilometraj ____________________________, la autovehiculul

sus numit conform devizului de montaj nr._________________________________________________________s-au efectuat
următoarele operaţii: ___________________________________________________________________________________
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Prelucrări mecanice conexe_______________________________________________________________________________
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În data de __________________________________________, kilometraj _______________________________autovehiculul

sus numit s-a prezentat în unitatea noastră cu următoarea reclamaţie de garanţie:
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După demontarea / analiza piesei am constatat următoarele: ____________________________________________________

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Părerea noastră este: ___________________________________________________________________________________
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Solicităm: _____________________________________________________________________________________________
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Data: Persoana care a efectuat constatarea:

Ştampila unităţii: Nume: __________________________________

Numar telefon: __________________________________

Semnătura: __________________________________

* Se completează obligatoriu toate câmpurile!