Complaints Book Establishment data TRADENAME: INVERNA PERÚ S.A.C ADDRESS: Calle Teruel 131, Pueblo Libre, Lima, Perú RUC: 20606590319 Claim Sheet Are you a minor? * YesNo Identification of the complaining consumer Identification of the claimant consumer representative First Name: * Middle Name: * Last Name: * Document type: * ---IDPassport Document No.: * Mobile: * Country: * State: * City: * Address: * Reference: * Email: * Detail of the claim and consumer order Claim Type: * ---ComplaintClaim Type of consumption: * ---ProductService Order number: * Claim Date: * Supplier: * Claim amount $: * Description of the product or service: * Date of purchase: * Date of consumption: * Date of Expiry: * Detail of claim/complaint, as indicated by the client: * Customer requirement: * (1)Claim: Disagreement related to products and/or services. (2)Complaint: Disagreement not related to products and/or services; or, discomfort or dissatisfaction with the attention to the public. *The formulation of the claim does not exclude recourse to other means of dispute resolution nor is it a prerequisite for filing a complaint with Indecopi. *The provider must respond to the claim within a period not exceeding thirty (30) calendar days, and may extend the term up to thirty days. *By signing this document, the customer authorizes to be contacted after processing the claim to assess the quality and satisfaction of the claims handling process. * I declare that I am the owner of the business/company and I accept the content of this form and the veracity of the facts described under Affidavit. Reconciliation Confirmation Upload your Document Upload a photo: * Upload a photo: * Upload a photo: * Claim Sheet Code: * Email: * Actions taken by the Entity: * * I send my documents and I accept the solution agreed in the conciliation and the actions by the business/company and finalize my claim/complaint. * I declare that I am the owner of the service and I accept the content of this form and that under Sworn Statement the solution described is true.