ICT Customer Receiving Form ICT Customer Receiving Form Date(Required) DD slash MM slash YYYY Time(Required) Hours : Minutes AM PM AM/PM Employee Name(Required) Name of employee who assisted customerCustomer (Full Name)(Required) Phone(Required)Email(Required) Model Number:(Required)Serial Number:(Required)Accessories Included:(Required) Add RemoveUnit Under Warranty:(Required) YES NO Problem as described by customer:(Required)Payment Received(Required) Cash Eftpos Cheque Please note that if there is failure to collect repaired/diagnosed equipment, VT Solutions reserves the right to auction or dispose off the equipment to cover the repair costs & storage if not collected within 30 Days of Notice. DIAGNOSIS FEE: diagnosis fee ($30) is applicable for any hardware related problem and or equipment that are out of warranty or void warranty. If the customer has agreed to terms please confirm what payment method they have used to pay the diagnosis fee.CAPTCHANameThis field is for validation purposes and should be left unchanged.
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