Return form

Standard form for exercising the right of complaint:

To: MILOTKA EOOD with UIC 206293003

I hereby notify you that I have discovered a discrepancy between the goods and the agreed upon goods.

Subject of the complaint: …………………………………..

Ordered on/received on: …………………………………

Preferred method of satisfaction (circle the desired option):

• Refund of the amount paid
• Replacing the product with another one that corresponds to the agreed upon

I am attaching the bill of lading received from the supplier.

Amount of the claimed amount: …………………………………………………………………………

User name: …………………………………………………………………………

Address of the user(s): …………………………………………………………………

User signature (only when submitting paper): …………………………………………………………………………

Date: …………………………………