Signoff Removal Page
Fields marked with
*
are required
*
Store Number
*
Manager Name
*
IRD U/A
IRD S/N
*
Signal Strength
*
BER
*
Was site trained on new connections?
Yes
No
*
Was equipment wired up using stereo RCA cables?
Yes
No
*
Was the VCR and TV connected using Input 1?
Yes
No
*
Contractor Company
*
Technician Name
*
Date rewiring completed
MM
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2007
2008
2009
*
Time rewiring completed
HH
1
2
3
4
5
6
7
8
9
10
11
12
:
MM
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
PM
AM