quality assurance returns / consumer complaint

VIESUN INC. 2135 PORTAGE street, LAVAL, QUEBEC, H7Y 0A3, CANADA (450) 978-0057
QUALITY ASSURANCE RETURNS / CONSUMER
COMPLAINT FORM / FORMULAIRE DE RETOUR OU DE PLAINTE
REPORT NUMBER: Q20__ __ __ __ __ __ __ __ (Q-O-M-B-A Select one)
PRODUCT NAME:
LOT #:
SIZE:
EXPIRY:
UPC:
CUSTOMER INFORMATION CLIENT
NAME / Nom: ______________________________________________________________________________
ADDRESS / Adresse: ________________________________________________________________________
PHONE # / Téléphone: (
)
CONSUMERS INFORMATION CONSOMMATEUR
NAME / nom du consomateur: _________________________________________________________________
ADDRESS / Adresse: ________________________________________________________________________
PHONE # / Téléphone: (
)
COMPLAINT / Plainte et remarque: (Ex: Rougeur)
NAME AND SIGNATURE OF ACCOUNT MANAGER HANDLING THE RETURN:
__________________________________________________________________________________________
HAVE YOU REPLACED PRODUCT WITH CAR STOCK (Y/N)?
Yes
DATE:
Please submit this to: VIESUN INC with the product.
SVP faire parvenir à Viesun inc. avec le produit
No