Standard form for exercising the right of complaint:

To. 

I/we hereby inform you that I/we have discovered a discrepancy between the goods/services/services and the agreed price.

Subject of the claim:

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

Ordered from/received at - .......................................

Preferred method of satisfaction(circle the desired option):

• Refund of amount paid
• Replacement of the goods with other, corresponding to the agreed
• Price discount
• Free repairs under Articles 113 and 114 of the Consumer Protection Act

I attach the following documents (circle the desired option):

• receipt or invoice;
• protocols, acts or other documents establishing the non-conformity of the goods or services with the agreed;
• other documents establishing the basis and amount of the claim.

Amount claimed: ...........................................................................

Username(s): ...........................................................................

Address of user(s): ...........................................................................

User signature (paper submission only): ...........................................................................

Date: .......................................