Customer collection of complaint form

INFORMATION ABOUT THE CLIENT

Name:
Phone:
Address:
Contact name
The contact function:
Purchase order number:
Invoice number:
Product number:
Description of the product:

THE COMPLAINT INFORMATION

Date:
Complaint registered by:
Details:
First reply for corrective action:
Suspected cause:
Person having undertaken corrective action:
Follow-up of the corrective action:
What are the arrangements to prevent recurrence of the problem:

Date:

Signature of person completing the complaint