New complaint

First Name *

Last Name *

Email *

Phone Number *

Street *

Number *

ZIP Code *

City *

Order Number

Date of purchase *

Date of receipt

 Date of detection of the defect *

Product name *

Price

Customer expectations Free repair of goods Replacement of goods for a new one Lowering the price of the good  Withdrawal from the contract and refund of the amount paid Undefined

 Bank account number

Serial number *

Buyer Consumer Company

Comments

* Required