Service Report

Date

Customer No

* All fields are required unless marked as optional

Vehicle Owner

Name

Street

City / Village

Postal Code

Country

Fleet Connect Member Number

Vehicle Manufacturer

Name

Country

Address of Garage / Repair Place

Name

Street

City / Village

Postal Code

Country

Phone Number

Contact Person

Name

Street
If Different

City / Village
If Different

Postal Code
If Different

Country
If Different

Phone Number

Type plate with serial number

Serial number stamped into the axle stub (right side)

Registration No.

Chassis No.

Date of registration*

Installation date of spare parts*

Km in service (read out from EBS/ABS)

* One of these fields must be filled in, the other is optional

Affected position on vehicle

	Left	Right	Axle lift
1st axle
2nd axle
3rd axle
4th axle
5th axle

Serial No. 1st axle

Serial No. 2nd axle

Serial No. 3rd axle

Serial No. 4th axle

Serial No. 5th axle

Date of repair

Tractor EBS:	Yes No
Trailer EBS:	Yes No

Detailed Complaint

Upload Photos (Optional)

Total size of all files must not exceed 10mb

Box		Platform
Tank		Concrete Mixer
Silo		Demountable
Low loader		Tipper
Other (describe below) Description (e.g. Wood Trailer)

Service Report

Trailer Suspension Systems

Vehicle Owner

Vehicle Manufacturer

Address of Garage / Repair Place

Contact Person

Type plate with serial number

Serial number stamped into the axle stub (right side)

Affected position on vehicle

Vehicle Type

Body Type

Upload Photos (Optional)