Complaints Book

COMPLAINT FORM 011

In accordance with the Consumer Protection and Defense Code, we provide a Virtual Complaints Book for your use.

Project*

RUC

Company Name

Address

Claim Date

First Name(s)*

Lastname*

Mother's last name*

Address (Full)*

Document Type*

Document number*

Phone or Mobile*

Email*

Product* Service*

Claimed Amount

Details (Max 2000 characters)

0/2000

Claim: Dissatisfaction related to products or services

Complaint: Dissatisfaction not related to products or services; or discomfort or dissatisfaction with customer service

Claim* Complaint*

Details (Max 10000 characters)*

0/10000

Request (Max 10000 characters)

0/10000

Response Communication Date (dd/mm/yyyy)

Details (Max 250 characters)

0/250

This field will be filled in by the provider when responding to your complaint or claim

Recipient (consumer, provider, or INDECOPI as appropriate)

Filing the complaint does not prevent resorting to other means of dispute resolution nor is it a prerequisite for filing a report with INDECOPI.

The provider must respond to the complaint within no more than fifteen (15) business days.

I have read and agree with all the information described in this complaint*