JOB REF: AF3870

DATE : 30.11.2021

COLLECTION FORM RETURN FORM

Name : Surendran R Contact Person :

Address : No 6 Jalan DBP3 Telephone :
Dolomite Business Park Facsimile :
Batu Cave, Selangor Mobile No :

NO. ITEM DESCRIPTION SERIAL NO./PART NO./MODEL NO. QUANTITY

1 Viora Main Board P/N: AS30550-A; S/N:VI-160701714 01
2 GUI Board P/N: AS30000; S/N: VI-130711557 01
3 RF Board P/N: AS30150-A; S/N: VI-160600909

APPROVED FORENSICS SDN BHD Acknowledged / Received by:

Name : Name :
Date : Designation :
Company Stamp :

[AGI-AF-CFDO-001]