Complaints book

Select type Individual Legal entity

Paternal surname* Maternal surname*

First names*

Company name*

Tax ID* Representative*

Document No.*

Phone/Mobile* Email*

Are you under 18? Yes No

Guardian name*

Contact address

Address*

Date of incident / service Description of contracted good or service* Claimed amount (optional)

Type Complaint Grievance

Complaint: dissatisfaction with product/service. Grievance: dissatisfaction with customer service.

Details* Consumer request*

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