Establishment of complaint

Invoice number:

Name:

Enter the name of the complained product

Product code:

Type of complaint:

Preferred complaint solution:

Reason for complaint:

The contain of package for sending:

Your data:

Name and Surname:

Enter the contact person

Street:

Enter the street and house number

City:

Enter the name of the town (village)

ZIP / postal code:

Enter the postcode of the town (village)

Country:

Telephone number:

Enter your mobile phone number in a preferred form, eg +421905xxxxxx

E-mail:

enter your e-mail

Bank account:

Enter your bank account number

Type of delivery:

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