SERVICE REQUEST FORM

Energy Efficiency Standards and Labeling Program - Data Information Sheet

Date & Time

Dear LATL Customers:

In line with the DOE-ERTLS continuing effort to serve you better, specifically in the processing of request for validation of energy labels, may we request concerned company to fill out this form. Please write legibly. Thank you for your usual cooperation.

Name of Company

Company Address

Contact Person

Position

Contact No

Email Address

Signature

Sample/s Received By

Assigned Company Code

Validation of Energy Labels - Air Conditioner

Date & Time *

Name of Company

OEM

Company Address

Address

Brand Name

Address

Type

Generic to: (Base Model)

Model No

(copy)

Cooling Capacity

kJ/h

Power Input

EER

kJ/W-h

Voltage Supply

Last control no. used

Quantity

Submitted by

Position

Received by

Date & Time

Designation

Department of Energy Philippines

Online Services Management System

SERVICE REQUEST FORM