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Name, Company. Address <br />Description of Repair or Remedy & Phone Number of <br />Defect Person Who Performed <br />Date of Description of Defect Date/Time List each component repaired, replaced and/or installed ]n <br />of Repair including the make, model and serial number <br />Re it <br />E <br />LI <br />0. <br />ca <br />C3 <br />C3 <br />C) <br />h' <br />CO <br />