Unitate emitentŁ:_____________________________
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!
