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PERSONAL DETAILS

Dr Mr Mrs Miss Mdm Company Name

Name :

(*)

Address :

Postal Code :

Contact :

Home
Office
Fax
Headphone
Email	(*)

TYPE OF SERVICE REQUIRED

AirCon Repair & Troubleshoot
AirCon Service
Chemical Cleaning
Maintenance Contract
Preferred Date:
Preferred Time:	Morning Afternoon

AIRCON DETAILS

BRAND

Carrier Daikin Fuji Air Fuji Electric Fujitsu General

Hitachi LG McQuay Mitsubishi Electric Mitsubishi Heavy

National Panasonic Samsung Sanyo Toshiba York

TYPE OF EQUIPMENTS

Window unit	Qty		Model:
Wall mounted unit	Qty		Model:
Casement unit	Qty		Model:
Ceiling cassette	Qty		Model:
Ceiling suspended unit	Qty		Model:
Ceiling ducted unit	Qty		Model:
Condensing unit	Qty		Model:

DESCRIPTION OF SYMPTOMS

Not working	Fancoil water leaking
Not cold	Fancoil noisy
Trunking condensation	Fancoil smelly
Gas leaking	Horizontal vane not working
Trip power supply	Horizontal vane not broken
Outdoor water leaking	Remote controller not working
Outdoor unit noisy	Remote controller no display

Describe the fault in details:

Headlessteam store

135/29 Tran Hung Dao, Cau Ong Lanh Ward, Dist 1, HCMC

Hotline: 076 518 5388

Email: headlessteam@gmail.com

Facebook: www.facebook.com/headlessbymn

Instagram: headless.team

135/29 Tran Hung Dao, Cau Ong Lanh Ward, Dist 1, HCMC.
076 518 5388

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