Claim form
Correspondence address of the receiving warehouse: (attach a copy of the tax document)
ARTURE Art and Nature, s.r.o
U Piskovny 376
344 01 Domazlice
eshop@a-n.cz Tel.: +420 +420 778 110 961
Order number:_____________________________
Date of delivery/receipt of goods:___________________ Date of complaint submission:__________________
Complainant
Company:__________________________________________________________________________________________________
Entire name:_______________________________________________________________________________________________
Address:___________________________________________________________________________________________________
Telephone:_________________________________________________________________________________________________
E-mail:______________________________________________________________________________________________________
Product ID_____ ________________________________________________________________________________________________________
Name___________________________________________________________________________________________________________________
Quantity________________________________________________________________________________________________________________
Price_____________________________________________________________________________________________________________________
Reason for complaint / detected defect
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
Proposed method of handling the complaint
___________________________________________________________________________________________________________________________
…………………………………
Complainant's signature
Complaint processed on: ______________________________________________________________________________________________
Complaint processing method:________________________________________________________________________________________
Name and Surname:
Signature of the person handling the complaint_____________________________________________________________________