Complaints Book

    Identification of the Claiming Consumer

    First Name(s)

    First Last Name

    Second Last Name

    Document Type

    Document Number

    Phone Number

    Department

    Province

    District

    Address

    Reference

    Email Address

    Are you a minor?

    Document Type

    Document Number

    Claim Details and Consumer Request

    Type of Claim

    Type of Consumption

    Order Number

    Date of Claim / Complaint

    Supplier

    Claimed Amount

    Description of the Product or Service

    Purchase Date

    Consumption Date

    Expiration Date

    Details of the Claim / Complaint, as stated by the consumer

    Consumer Request

    (1) Claim: Nonconformity related to products or services.

    (2) Complaint: Nonconformity not related to products or services; or discomfort or dissatisfaction regarding customer service.