Complaint form

Place, date:

 

MUSEUM OF MODERN ART IN WARSAW
ul. Pańska 3
00-124 Warsaw

 

First name Last Name:

Consumer's address:

Order no .:

 

Complaints about the goods

 

I hereby inform that the goods purchased by me on ………… are defective. The defect consists in …………………………………………………………………………………………………………………………… The defect was found on ………………………. Due to the above, on the basis of the Act of April 23, 1964, the Civil Code, I request:

 

replacement of the goods with a new one * (Article 561 § 1)
lowering the price of the goods by the amount of ........................ (in words: …………………………………………………) PLN, I am asking for a refund of the given amount to my account ……………………………………………… ………………………………………………. / By postal order to my address * (Article 560 § 1)
I withdraw from the contract and ask for a refund of the price of the goods to my account ............ * (Article 560 § 1)
 

 

Yours sincerely,

 

 

 

* delete as appropriate