Admin-01

Independent Media Corporation (Pvt.) Ltd.

Cellular Phone Set Maintenance Form

Date:
18 April 2024
Emp Code: P-2397 Name Mohammad Rizwan Sheikh
Designation: Cameraman Department News
Mobile # Iphone Model # 6S IMEI # 35570073195462
Battery # Unnoon Charger Nill Fault Date 15th. April 2024
Problem Screen,Charging, Camera,Battery,

Employee Signature Station Peshawar

ISSUED TO – (for repair)

Person Name Company Name

Date of Issue Date of Return Cost

Problem Diagnosed

Payment through Company/Employee/Insurance

Management Approval

CELLULAR PHONE RETURN TO EMPLOYEE (for Admin use)

Name Designation

Department Mobile # Model #

Battery # Charger # IMEI #

Others Date of Issue

Admin Representative Remarks

Received by Signature