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Material Request Form: Richard Mottey

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MATERIAL REQUEST FORM

CUSTOMER INFORMATION
MRF No.: Date: Company/Customer Representative Location
31/10/17 IPX CERAMICO

REQUESTER INFORMATION
Requester: Department: Department Operations Date: Requester
Head/Approved Manager / Signature
Approval
Richard NUBEE Jose Norberto Eyi Esono
Mottey Mbengono   /
INVENTORY INFORMATION
INVENTORY REPRESENTATIVE LOCATION SIGNATURE

Agustina Consuelo Ela Baby Punta Europa

Device Information
Qty Description Model/P.N S/N: Additional Incomple
Information
1 Infinet Radio HSU R5000 – 221751 Complete
Smnc/32.300.2x200.2x19
I8
1 POE MIT-07T-2024 163015184D Complete
RC04
1 CISCO SWITCH WS-C2960-24TT-L V03 F0C1141Z8Y4
1 MEGALEC AC SVC-5kVA L0427317 Complete
AUTOMATIC VOLTAGE
REGULATOR
1 PDU Complete
1 9 U RACK Complete
1 3000VA SMART UPS SUA3000I AS1228144520 Complete

Purpose:

Installation Replacement Good Sold Test Relocation

Other (please explain)

1
MATERIAL REQUEST FORM
Device History (Filled by Inventory)
S/N Previous Location Problem found Status Comment

Replace Device (Fill this place with the faulty device)


Qty Description S/N: Previous Location Incomplete
Model/P.N

MR FORM POLICY

Please follow these 4 simple steps to return equipment.


1. Send a notification trough email to create a new ticket to use the device within 24 h to get the MR
FORM number.
2. Make sure the device is complete and works properly
3. If the device is not complete, place a check in the “Incomplete” column and describe the discrepancy
bellow.
4. Company/Customer: Should be filled with the place where the device is will be used.
5. Additional Information: please add the frequency, Size, Voltage etc.
6. Operation Manager will approve if there is any need.

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