40
COMPLAINT CALL
NO.
DATE
Data of Customer making the claim:
Customer's name and surname / Company name
.........................................................................
City
................................................................................................
Postal code
....................................................................................
Street
.............................................................................................
Tel.
.........................................
Fax
.................................................
Machine name and code
................................................................................ T
Date of
purchase
Serial
number
Year of
manufacture
Place of purchase:
..........................................................................................................................
/Dealer's name, city/
1. When and under what circumstances was the failure discovered?
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
2. Comprehensive fault description
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
3. Customer's proposed mode of the warranty claim processing
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
(legible signature of the customer who filed the complaint)
NOTE: If the complaint is found to be unjustified, all complaint processing costs will be
charged to the complaint applicant.
Customer complaint placed by phone
date
......................................................
Dealer's stamp
Legible signature of the outlet representative
