Complaint Form
for the www.pow.sk e-shop
Correspondence address: Mário Harman – www.pow.sk, Záhradnícka 698/38, 920 41
Leopoldov, Slovak Republic
Customer
Name and surname:
Address:
Phone No.:/email address:
Goods/service that is the subject of the complaint
No. of the purchase receipt or letter of warranty:
Name:
Date of purchase:
Accessories:
Description of defect:
______________________________________________________________________________
I would like to have my complaint handled in the following manner (tick your preferred option):
□ Goods exchange □ Goods repair □ Money return □ Purchase price discount
□ Other..............................................................
If the complaint is resolved through the return of the purchase price and you wish to have the money
returned to your bank account, please provide the IBAN number:
In(place): .................................... on(date): …………………
............................................
Customer signature