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CONSUMER COMPLAINT FORM

(In accordance with the Consumer Protection and Safety Act No. 30 of 1985)

Please note we can only assist with complaints where the goods and services are advertised and purchased in Trinidad and Tobago - for those outside Trinidad and Tobago please refer to your local Consumer Agency.

CONSUMER INFORMATION

* Required Fields

First Name

*

Last Name

*
Middle Initial

Occupation

*

Address (Street)

*

Age

*
Address  (cont.)

Gender

*

City/Town

* E-mail

Phone

* FAX
Work Phone    


SUPPLIER INFORMATION

Business name Business contact
 Address Fax
City/town E-mail
Phone
If Yes, describe

Have you contacted
  the supplier 
  

PRODUCT / SERVICE INFORMATION

Product/service involved Brand
Country of origin Model No. 
Date of purchase Serial    No.
Guarantee/
warranty
Length (months)


Technical Information

Date of manufacture  Standards mark
Electrical frequency rating Required voltage
Describe the facts of your complaint What is considered a satisfactory solution  

By submitting this complaint form, I certify that the foregoing statements made by me are true and correct to the best of my knowledge and belief. I am willing to testify to any proceedings related to this complaint if required.


   
 

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