COMPLAINT FORM PAWBOL Spółka z o.o. AQZ - 30 Edition 4 Valid from: 11.09.2014 Name of issuing the notification: COMPLAINT FORM number ______ Company name/stamp: Date: Address: Lp. 1 2 Name of goods (code, part Quantity number) The claimed defect item or element - faults / defects / problem DESCRIPTION Invoice number: Date of invoice: Invoice number: Date of invoice: Signature of claimant: Telephone number of claimant: Repair: The method of investigating Exchange for the complaint new by Pawbol Credit note Invoice number: Other : Date, name and signature of examining the complaint: Place and date: RECEIPT OF GOODS AFTER CLAIM REALIZATION Name and signature of receiving person :
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