Standard claim form:

To: Estira Ltd  with UIC 205864538

I hereby inform you that I have found a mismatch of the product (s) / service (s) with the contract.

Claim subject:

…………………………………………………………………………………………………………………………………………

………………………………………………………………………………………………………………………………………..

………………………………………………………………………………………………………………………………………..

Ordered on / received on - ………………………………… order number……………..…………….………

Preferred way of satisfaction (tick the desired option):

• Refund
• Replacing the product with another one that is agreed upon
• Price drop
• Free repairs according to Art. 113 and 114 of the Consumer Protection Act

I am attaching the following documents (tick the desired option):

• cash receipt or invoice;
• protocols, acts or other documents establishing the non-conformity of the good or service with the contract;
• other documents establishing the claim by reason and size.

Amount claimed: ……………………………….……………….…….…………………………………..……………

Username (s): ………………………………………………………….……………………………………………….

User Address (s): ………………………………………………………………………………………………………

User's signature (paper submission only): ……………………………………………………...........……………

Date: …………………………………