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Pessoa Física
Pessoa Jurídica

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Technical Service Request

Customer:

Account Number:

Date:

Full name:

Cellphone:

Address of the crane's location for repair:

Billing Adress:

Email:

Telephone:

Crane model:

Serial number:

Describe the type and reason for the service call:

YOUR PURCHASE ORDER NUMBER:

This document will be sent by email and must be signed by the tenderer of the requesting company.

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