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Complaint form

Complaint form 
Online store homba.sk
MAD Solutions s.r.o., Tokajská 11, Košice 040 18, Slovak Republic
The customer 
Name and surname:
Address:
Phone number/ email address:
Advertised goods/services 
Number of the proof of purchase or warranty card:
Title:
Date of purchase:
Fault description:
________________________________________________________________________________
I propose that my complaint be processed in the following way /check the required one/:
□Exchange of goods □Repair of goods □Refund □Discount from the purchase price □Other................................. ............................
On .................................... on: ……………
............................................
Customer signature