Claim Form

Sample Claim Form

 

NATIBABY Tomasz Zimniewicz
ul. Szczepankowo 146D/2
61-313 Poznań
POLAND
shop@natibaby.com
NIP 766-141-60-66

Name and surname:...................................................................................................................

Street: .................................................................................................................................

Zip code: .................................................

City: ...................................................

Telephone: ......................................................

Email:..............................................................

 

Description of goods (e.g. type, model - symbol): .........................................................……………….

Order number: ....................................................

Order Date / date of contract of sale conclusion: ...................................................

Number of VAT invoice / receipt and date of issue (optional) or other proof of purchase .......................................

...............................................................................

 

Description of the defect: ........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................ ................................................................................................................................................................... ...................................................................................................................................................................

 

Date when the defect was recognized: .......................................................................................

 

 

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    Date and Customer(s) Signature(s)s