检测报告修改申请表

1、壹腔眼务信心之本Comflc*«K0 Through T«ctwxMogyciim®检测报告修改申请表REQUEST FOR REPORT AMENDMENT/RE-ISSUE申请信息：Application Information公司名称 Company Name :联系人Contact :电话Tel:传真Fax:电邮 E-mail:取报告方式 Report pick up:自取 Self-pick up 匚| 快递 Express邮寄报告地址 Report Delivery To:报告信息：Report Information1原报告编号 Original i

2、ssued report(s) No.:2是否已收到正本报告 Report(s) received or not:是Yes否No更改信息 amending information :(请列明更改内容以便审核)(please list amending content to auditing)原报告内容(original report content)须修改内容(amending report content)注意事项：Notice1. 如申请重新发出之报告，而原报告因故不能归还中鼎检测技术有限公司，则原报告在本申请被接纳时将自动作废；On the caseof report re-issued

3、 which original one can not be returned to CTT, the superseded report(s) should be invalid once thisrequest is accepted;2. 每份报告的修改或多出一份报告的费用为人民币50元；RMB 50 will be charged for one more report issued or one reportamended.3. 报告的修改周期为一个工作日；The period of report amending is one working day.4. 若涉及多份报告的修改，请

4、以附表的方式列出修改清单并加盖公司印章；If refer to several reports amending, pleaseaccording attachment to list amending content and cover company chop.本人将承担因上述报告内容更改所造成的任何责任及费用，特此声明：I hereby declare that we would take the responsibility forchanger of information to the report(s) mentioned above and would agree to pay

5、 any charge incurred for this service.申请人签名、公司印章及日期Consumer Testing Technology Co .Ltd, 中鼎检测技术有限公司Signature, Company Chop& Date以下信息由 CTT 填写：CTT fill in the below information客户修改报告原由：the cause of amending report by client重新编印的报告编号Reprint the issued report(s) No.:技术负责人TechnologyManager客服部会签Custome

6、rService主管审核Director经办人TransactorBuilingi 6 .Sciitwi & .Norih*m ineu 訓灿 I Dlairtcl.Sorflsfian Te-hS6-7S9F qjc 86- 7698 08UkaSa &Tech iF*dgry PMcDoogguiG叩Emaid #nquirycit17C2S cmn 'wrMUb com东 WLUWS 产 1北 UH 业陣 *Halins: 4006 7B9 朋自申请单附表：applicati on attachme nt序号NO.报告编号report NO.原报告内容 original repo