Complaint Receipt and Handling Report

CONFIRMATION OF DEFECT NOTIFICATION
Online store: www.titzmach.com
Communication address: Mária Lazarová, Žitavská 175/17, 95197, Žitavany, Slovak Republic

Buyer details:
Buyer address:
*Email contact:
*Phone contact:
Complaint number:
Product under complaint:
Date of purchase:
Date defect noticed:
Date of receipt of the returned product:
If a defect exists, it will be resolved by:
Proposed method of complaint handling by the buyer:
*Order number:
*Proof of purchase reference:
Buyer’s bank account number:
(-optional information)

Defect described by the buyer:

…………………………………
Seller’s stamp and signature

DEFECT HANDLING REPORT
Online store: www.titzmach.com
Communication address: Mária Lazarová, Žitavská 175/17, 95197, Žitavany, Slovak Republic

Buyer details:
Buyer address:
*Email contact:
*Phone contact:
Complaint number:
Product under complaint:
Date of purchase:
Date complaint submitted:
Date of receipt of the returned product:
Proposed method of complaint handling by the buyer:
*Order number:
*Proof of purchase reference:
Buyer’s bank account number:
(-optional information)

Defect status:
□ acknowledged □ rejected

Method of complaint resolution if acknowledged:
□ replacement with a new item
□ refund
□ discount on purchase price
□ repair: ..................................................................................................................................................
□ other: ..................................................................................................................................................

Seller’s statement:

………………………………
Stamp and signature