PLEASE NOTE: YOU MUST CONTACT DLC PRIOR TO RETURNING GOODS.

DLC Australia Pty Ltd

Phone. (03) 9360 9700Fax. (03) 9360 9994Email. info@dlc.com.au

REQUEST FOR CREDITDear Customer, please ensure that you fill out all of your details to ensure timely processing of your request.

Proof of purchase must be provided for warranty/credit claims. Failure to provide proof of purchase will result in charges for the service provided.

Company Name.

Contact Name.

Phone. Fax.

Email.

Address.

Address.

Product Description.

Serial Number.

Purchase Date& Invoice #DLC Contact Name.

Fault or Reason for Return.

Accessories Included.

PLEASE NOTE: IF FORM IS NOT RECEIVED WITH GOODS, YOUR REQUEST CANNOT BE PROCESSED.

Extra Notes.

DLC Australia Pty Ltd 17-19 Horne St, Hoppers Crossing, VIC, 3029

www.dlc.com.au

Date Sent by client: / / 20

Req

uest

for C

redi

t (Ja

n 20

16)

PLEASE SEND GOODS TO:

Date Received at DLC: / / 20

Date Credited/Repaired: / / 20 Date Shipped by DLC: / / 20

To avoid a cleaning fee of $100, ALL Equipment should be cleaned and free of biological matter.

Service Order #