Complaints

SAMPLE COMPLAINT FORM

Vineyard & Wine Sp. z O. O.

Plk. Dabka 8

30-732 Krakow

Subject of complaint:



...................................................................................................................................................



Invoice number ..........................................................................................



Date of conclusion of the contract/receipt ..................................................................................................



Consumer's name .....................................................................................................



Consumer's address ....................................................................................................................



Report of complaint (description of defects and circumstances under which they occurred):



........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................ ......................................................



When the defects were found ...............................................................................................................



Remedial action/demand of the complainant:



(___) replacement of the item with a defect-free one,

(_) withdrawal from the contract.



In case of withdrawal from the contract, please return the amount paid to the bank account No............................................................................................................................



Date ....................



Signature......................