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Date of acceptance / Дата приема /
Saņemšanas datums / Priėmimo data
/ Vastuvõtu kuupäev / Aufnahmeda-
tum / Datum van ontvangst / Date
d’acceptance
Stamp of service
center / Печать
сервисного цен-
тра / Servisa cen-
tra zīmogs / Aptar-
navimo centro
antspaudas /
Teeninduskeskuse
pitser / Siegel des
servicebetriebs /
Stempel van ser-
vicecentrum /
Sceau du service
client
Issue date / Дата выдачи /
Izsniegšanas datums / Išdavimo data
/ Väljaandmise kuupäev / Ausga-
bedatum / Datum van uitgifte / Date
de délivrance
Defect / Дефект / Defekts / Defektas /
Rike / Defekt / Gebrek / Défaut
Executed work / Выполненная ра-
бота / Izpildītais darbs / Atlikti dar-
bai / Tehtud töö / Durchgeführte Ar-
beiten / Gedane werkzaamheden /
Travail produit
Expert (full name) / Специалист
(имя) / Meistars / Meistras / Spetsi-
alist (nimi) / Fachspezialist (name)
Vakkundige (naam) / parateur
(nom, prénom)
Filled in by service center / Заполняется сервисным центром / Aizpilda servisa centrs / Pildo aptarnavimo centras /
Täidab teeninduskeskus / Wird von dem Servicebetrieb ausgefüllt / Wordt ingevuld door het servicecentrum / À remplir
uniquement par le service client
Date of acceptance / Дата приема /
Saņemšanas datums / Priėmimo data
/ Vastuvõtu kuupäev / Aufnahmeda-
tum / Datum van ontvangst / Date
d’acceptance
Stamp of service
center / Печать
сервисного цен-
тра / Servisa cen-
tra zīmogs / Aptar-
navimo centro
antspaudas /
Teeninduskeskuse
pitser / Siegel des
servicebetriebs /
Stempel van ser-
vicecentrum /
Sceau du service
client
Issue date / Дата выдачи /
Izsniegšanas datums / Išdavimo data
/ Väljaandmise kuupäev / Ausga-
bedatum / Datum van uitgifte / Date
de délivrance
Defect / Дефект / Defekts / Defektas /
Rike / Defekt / Gebrek / Défaut
Executed work / Выполненная ра-
бота / Izpildītais darbs / Atlikti dar-
bai / Tehtud töö / Durchgeführte Ar-
beiten / Gedane werkzaamheden /
Travail produit
Expert (full name) / Специалист
(имя) / Meistars / Meistras / Spetsi-
alist (nimi) / Fachspezialist (name)
Vakkundige (naam) / parateur
(nom, prénom)
Filled in by service center / Заполняется сервисным центром / Aizpilda servisa centrs / Pildo aptarnavimo centras /
Täidab teeninduskeskus / Wird von dem Servicebetrieb ausgefüllt / Wordt ingevuld door het servicecentrum / À remplir
uniquement par le service client
104


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