Defect complaint form
Online store www.wvagon.com
Address for communication: Dávid Lazar, A. Stodolu 162/12, 971 01, Prievidza, Slovak Republic
Customer
Name and surname:
Address:
Telephone number/email address:
Complained goods/service:
Number of proof of purchase or warranty certificate:
Name:
Date of purchase:
Accessories:
Description of defect:
____________________________________________________________________________
I propose that my complaint be handled in the following way /check the required/:
□Exchange of goods □ Repair of goods
In case the complaint is handled by refunding the money and if you wish to send the money to the bank account, please provide its number:
On ..................................... date: …………………
............................................
Customer's signature