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Customer fill this part |
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Customer´s name (identification number): |
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Customer´s address: |
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Shipping address (in case of different customer´s address): |
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Home or mobile telephone number: |
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E-mail: |
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Comment: |
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Name of defective goods: |
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Date of purchase/issue an invoice: |
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Invoice number: |
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Details of what the customer complaint is:
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Customer´s proposal of complaint settlement:
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Date and customer´s signature: |
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Notice: Protect reclaimed goods from damage during shipping. |
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Office use only |
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Date of received complaint: |
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Complaint settlements person: |
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Seller´s comment:
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Date action completed and signature: |