Service Order Summary
Request ID: [ ] Open Date: [ / / : ]
Product Desc.: [ ] Serial Number: [ ]
Customer Name: [ ]
Customer Address: [ ]
Caller Name: [ ] Phone [ ]
Travel Date: [ / / : ] Email: [ ]
Arrive Date: [ / / : ] Meter Reading
Completion Date: [ / / : ] Total BLK: [ ]
Engineer Name: [ ] Total CLR: [ ]
Word Order Summary: _________________________________________________________________________________
Symptom Code: [ ] Cause Code: [ ] Action Code: [ ]
Remarks: ____________________________________________________________________________________________
Item usage
Part Number Description Quantity Price (HKD)
Parts Charges
Labor Charges
Total (HKD)
Authorized signature and
company chop
Customer Name Date/ Time
Remarks: 1. Ricoh does not keep any record of customer’s password.
2. This is a record of your endorsement of our service in good order. We reserve the right to produce this
record for reference or other purpose, if needed.