NEOLITE ZKW Lightings Pvt. Ltd.

SAMPLE REQUISITION FORM

SMPL
FROM : EXPORT CUSTOMER’S NAME : SPAREX
REQN. 19-34
MKTG. KIND ATTN.: MR. C. K. MISRA FORM #

SMPL. APLCN. DATE : SMPL RQMT. DATE : ASAP Mr. Girish Bansal
25/02/2020
Traffic:  LHD  RHD ROUTINE SAMPLES YES NO

S ITEM ITEM QTY BLB Purpose of Sending Samples REMARKS

NO NO. DESCRIPTION PCS FTMT
1 NEO-608 5
2 NEO-791 5
3 NEO-774 M28 5
4 NEO-774 M18 BLUE 5
5 NEO-874 RED 5

SAMPLE REQUISITION
SIGNATURE OF MARKETING HEAD SAMPLE COMMITMENT DATE
APPROVED BY