Complaint report


Date:	*
Company:	*
Address:	*
Tel:	*
Fax:
Responsible person:	*
E-mail:	*

Invoice No.	Index Quantity Price(net)

Reason of complain: inconsistent with order inconsistent with invoice customer's mistake wrong price other	Notes:

Request: replacement of goods replenishment change of price return money on bank account number other	Notes:
bank account number:

tel: +48 58 622 89 00

fax: +48 58 622 47 66