Format No: SPLTAPL/RR/7.1.2

Service Request Form

(To be filled by customer)

SRF No:

1. Contact Details:

Name:

Email:

Mobile No:

Department:

Designation:

Organization Name:

Address:

State:

Pin Code:

GSTIN:

(Please mention correct GSTIN. SPLTA will not be responsible for any consequences caused by furnishing of Incorrect GSTIN)

2. Previous Communication Details:

2.1 SPLTA Quotation no./ Ref no: & date:

2.2 Our purchase or Service Order Number:

3. LAB - PCL (Pressure Calibration Lab)

3.1 Type of Service: Calibration Others:

3.2 Details of Equipment:

Sl. No.	Equipment Name	Range (along with units)	Model No	Serial No / Identification No	Calibration Points	Quantity	Mode of Calibration	Remarks
1
2
3
4
5

4. Advance Payment Details:

NEFT / RTGS as per following details Details shall be communicated before commencement of calibration, by email

Date of Payment	Amount	UTR / Transaction details	IT TDS Amount deducted*	IT TDS % deducted*	TAN

* Form 16A will be submitted within 45 days from end of quarter in which deduction was made.
~ In case you are authorized to make deduction of GST at source under section 51 of CGST Act

5. Calibration Requirement:

DKD R-6-1 (Applicable)

Next Calibration Due Date Required in certificate: Yes No

Note: The instrument shall be calibrated whenever the instruments suffer any damage or has been subject to any repair

6. Address in Certificate / Report:

Same as in page 1 As mentioned below

State:

Pin Code:

Note: If the calibration certificate is in the name of any other company, you have to submit a request letter in the letter head of the organization whose name has to be incorporated in the report

7. Equipment Return Mode:

Not Applicable We Will Arrange SPLTA to send back on “To pay” basis

8. Statement of Conformity:

Required Not Required

9. Decision Rule (if Statement of Conformity is required):

ILAC G8 (Without Guard Banding If result is within tolerance → PASS, If result is outside tolerance → FAIL) ILAC G8 (With Guard Banding Acceptance limit = Spec limit − Measurement Uncertainty) Customer Specified
Statement of conformity is based on ILAC G8 / ISO 14253-1: Measured Value ± Expanded Uncertainty compared with specification limits. No guard banding is applied unless specified by customer.

As per quotation terms and conditions are accepted by customer:

Yes

Customer Name / Signature:

Date:

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