Complaints book

Identification of the Consumer Claimant:

Names

Surname

Mother's Last Name

Document type
—Por favor, elige una opción—IDECPassport

Nro Document:

Cell phone:

Enter your Address:

District:

Province:

Department:

Email:

Type of Client: Natural PersonCompany

I am over Age If

Identification of the Consumer Claimant:

Type of Claim: Claim on products and/or servicesComplaint is dissatisfaction by the public

Identification of the contract: ProductService

Nro Proof:

Acquisition date:

Description:

Detail:

I declare to be the user of the service and accept the content of this form stating under Oath to the truthfulness of the facts described.