Part 4 Temporary Disconnection – Number of Machines required for temporary disconnection: Date & Time of Disconnection: (dd/mm/yyyy @ hh.mm am/pm) Date & Time of Reconnection: (dd/mm/yyyy @ hh.mm am/pm) Reason for temporary disconnection (E.g. painting, recarpeting etc) House Government Manufacturer’s Game Name Number Plate ID Number Serial Number
Part 4 – Temporary Disconnection Number of Machines required for temporary disconnection: Date & Time of Disconnection: (dd/mm/yyyy @ hh.mm am/pm) Date & Time of Reconnection: (dd/mm/yyyy @ hh.mm am/pm) Reason for temporary disconnection (E.g. painting, recarpeting etc) House Number Game Name Government Plate ID Number Manufacturer’s Serial Number