(B). Customer Complaint Form

Date of Complaint:

Customer Details

Name:

Address:

Phone:

Email:

Purchase / Service Details

Product / Service Name:

Date of Purchase / Service:

Invoice / Order Number:

Complaint Details

Nature of Complaint (please tick):

Product defect
Service issue
Billing/Payment issue
Delivery/Shipping delay
Other (please specify):

Description of Complaint:

Resolution Sought:

For Office Use Only

Complaint Reference No.:

Staff Handling Complaint:

Action Taken:

Date Resolved:

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