COMPLAINT FORM

Complaint

DATA OF THE CUSTOMER SUBMITTING THE COMPLAINT

Company name

TIN

Person

Phone

DATA ON THE ADVERTISED PRODUCT

FV number

Luxon order number (Information given on FV)

Full luminaire code 1

Binding 1

Number 1

Full luminaire code 2

Binding 2

Number 2

Full luminaire code 3

Luminare 3

Number 3

Full luminaire code 4

Luminare 4

Number 4

Reason for the complaint (Detailed description of the defect/ damage to the product and possible comments)

SHIPPING AND RECEIPT DATA

SHIPPING AND COLLECTION DATA - Pick-up/drop-off address - Place of installation of the product

Street

Zip code

City

Collection of the parcel by Luxon (payable)

Yes

Shipment dimensions (if marked above YES)

Length (cm)

Height (cm)

Width (cm)

Weight (kg)

Number (pcs)

Section

Upload attachments (Optional)

Maximum upload size: 50MB

e.g. photos, FV, Sales contract

Consent

I agree to be transferred to me by Luxon Sp. z o.o. commercial information via electronic means of communication within the meaning of the Act of 18 July 2002 on the provision of electronic services (Journal of Laws No. 144, item 1204, as amended).

I declare that I have read the privacy policy and agree to the processing by Luxon Sp. z o.o. z o.o. with its registered office in Krępice entered data entered by me for marketing purposes of own products and services.