COMPLAINTS FORM
for the purpose of asserting defects
SELLER CONTACT DETAILS:
VETlímce s.r.o. Company Registration No.: 11979160 Vltavínová 1334/3, Černice, 326 00 Plzeň
tel.: +420 734 562 220 e-mail: info@vetlimce.cz web: www.vetlimce.cz
INVOICE NUMBER (on the basis of which the order was paid):
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CUSTOMER CONTACT DETAILS (details for handling the complaint):
full name / company name: __________________________________________________
e-mail: __________________________________________________________________
telephone: _________________________________________________________________
address: __________________________________________________________________
GOODS SUBJECT TO COMPLAINT (name – number of units):
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DESCRIPTION OF DEFECT (subject matter of the complaint):
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PREFERRED METHOD OF RESOLUTION (how you wish the complaint to be resolved):
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DETAILS FOR REFUND OF PURCHASE PRICE (in the event that a right to refund of the purchase price has arisen):
I wish to have the purchase price refunded by bank transfer to the following account:
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I wish to have the purchase price refunded by other means:
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Customer's signature: ___________________ Complaint received by: _____________________
Date of signature: ___________________ Date of signature: ______________________