CUSTOMER COMPLAINT REGISTRATION FORM
To be completed by Customer & Returned Directly to Nat Shannon on email
Nat.Shannon@mjsfc.com.au
Date:
*
/
Month
/
Day
Year
Retailer Details
Name:
*
Contact:
*
Address:
*
Phone:
Mobile:
*
Account No:
Email:
*
Customer Details (Site):
Name:
*
Contact:
*
Address:
*
Phone:
Mobile:
*
Product Information
MJS Invoice No.:
*
Date:
*
/
Month
/
Day
Year
Product:
*
Colour:
Batch:
Metres related to complaint:
Invoice Price/Metre:
Installation Date:
*
/
Month
/
Day
Year
Installed By:
*
Installer’s Mob No:
*
Installer Qualification:
FCIA Membership No:
Type of Building / Rooms:
*
Subfloor Type:
Adhesive:
Inspected By:
*
Date Of Inspection:
*
/
Month
/
Day
Year
Details of Inspection:
*
0/200
Recommended Action:
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NO
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