Complaints book

Identification of the claimant consumer

Name

First Lastname

Second Lastname

Document

Document Number

Cellphone

City

Province

District

Address

Reference

Details of the consumer complaint and order

Type of claim

Type of consumption

Order Number

Date of claim / complaint

Amount claimed (S/.)

Details of the Claim / Complaint, as indicated by the customer: *

Customer request: *

I declare that I am the owner of the service and I accept the content of this form by declaring under oath the veracity of the facts described.

I have read and agree to the Privacy and Security Policy.

(1) Claim: Disagreement related to products and/or services.
(2) Complaint: Disagreement not related to products and/or services; or, discomfort or dissatisfaction with customer service.

* Filing a claim does not preclude recourse to other dispute resolution methods and is not a prerequisite for filing a complaint with Indecopi.
* The supplier must respond to the claim within a period not exceeding fifteen (15) calendar days, which may be extended by up to fifteen days.
* By signing this document, the customer authorizes the supplier to contact them after the claim has been processed to evaluate the quality and satisfaction with the claims handling process.

FMO'D

TIME TRAVELER 2025

ARTE-SANA 2024

Complaints book

Identification of the claimant consumer

Details of the consumer complaint and order

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