Damage Report |
Date: |
Customer name: |
Address: |
Home Phone: |
Technician on duty: |
Item(s) description: |
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Replacement value of item(s): |
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Please describe the incident that caused the damage: |
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Can item be repaired? |
Was customer notified? If yes, by whom? If yes, date and time: |
Please describe follow- |
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Cost: |
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Was insurance company notified? |
Date of insurance company notification: |
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