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CONSUMERS COMPLAINT
FORM |
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Use this form to submit a complaint
to the Center for Health Development – Davao Region,
about a particular company or organization. The information
you provide is up to you. However, if you do not provide
your name or other information, it may be impossible for
us to refer, respond to, or investigate your complaint or
request
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1.COMPLAINANT |
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1.1
RESPONDENT |
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2.
SUBJECT OF COMPLAINT |
(In case of bottled drink, please specify
the size) |
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3.
CAUSE OF COMPLAINT |
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4.
DATE OF PURCHASE/DELIVERY/ADVERTISEMENT |
in
Year- Month-Day
ex. 2006-01-09 for January 9, 2006: |
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5.
EVIDENCE |
a)
Do you have a receipt/invoice:
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b)
Any other documents/evidence proving the act complained
of: |
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c)
Name and Address of witness/es: |
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6.
WHAT SETTLEMENT WOULD YOU CONSIDER FAIR |
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the statement in this complaint
signifies true and correct to the
best of my knowledge |
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