Customer Complaint Form
RCI - Reza Chemical Industries - v2
Details
of the complainant/customer:
Date
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Company
*
Address
*
Mobile Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Tel
Please enter a valid phone number.
Format: (00) 000-0000.
Email
*
example@example.com
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Product details
Product Name
*
Pack Size/Quantity
*
Batch No / Prod & Expiry
*
RCI Manufactured?
*
Yes
No
Manufacturer Name
*
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Details of the complaint / Description of product fault
**Please provide sample to RCI, QC dept, with product spec (if non-RCI product)**
Details
*
Customer/Complainant
Corrective Action/Preventative Action:
Submit
Should be Empty: