Claims Book

COMPLAINTS BOOK

Identification of the complaining consumer * Required data

Name *

Last name *

Second last name *

Type of documentation *

Documentation number *

Cellular *

Department *

Province *

District *

Address *

Reference

E-mail address *

Are you a minor?

Yes

No

Father / Mother / Guardian

Name

E-mail address

Type of documentation

Document number

Details of the claim and order of the consumer * Required data

Type of claim *

Type of consumption *

Order No. *

Date of claim/complaint

Supplier

Amount claimed (S/.)

Description of the product or service *

Date of purchase

Date of consumption

Expiration date

Details of the Claim / Complaint, as indicated by the customer: *

Customer Request: *

(1) Complaint: Disagreement related to products and/or services.
(2) Complaint:Disagreement not related to products and/or services; or, discomfort or dissatisfaction with customer service.

I declare that I am the owner of the service and accept the contents of this form by declaring under Affidavit the truthfulness of the facts described.

* The formulation of the complaint does not exclude recourse to other means of dispute resolution nor is it a prerequisite for filing a complaint before Indecopi.
* The supplier must respond to the complaint within a period not exceeding fifteen (15) calendar days, with the possibility of extending the period up to fifteen days.
* By signing this document, the client authorizes to be contacted after the processing of the complaint to evaluate the quality and satisfaction of the complaint process.

I have read and accept the Privacy and Security Policy and the Cookie Policy.

COMPLAINTS BOOK

Identification of the complaining consumer * Required data

Father / Mother / Guardian

Details of the claim and order of the consumer * Required data

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Complaint book