Name*

Warranty Card no*

Surname*

Date of purchase*

Company name*

E-mail adress*

Phone number*

Warranty repairPost-warranty repair

If the service request concerns a device not covered by the warranty period, it is required that the reporting company / person is a payer for the service. Please also provide full details needed to issue an Invoice for the service:

Choose the type of broken turnstile:

Location of the installation site:

Company name:

Contact phone number*:

Contact person at the location of the installation site*:

Address*:

Contact person e-mail*:

Description of the fault*:

I agree to the processing of my personal data in accordance with the law on the protection of personal data in connection with (eg the implementation of the application). Providing the data is voluntary, but necessary to process the query. I have been informed that I have the right to access my data, the possibility of correcting it, requesting discontinuation of its processing. The administrator of personal data is Gastop LLC with registered office at 30 Wall St. 8th Floor, NY 10005 New York, USA.