Libro de Reclamaciones

Claims and Complaints Book

Use this form to submit a formal claim or complaint regarding our services.

Provider information Andrés Alonso Franco Urdanegui, RUC: 10704615022

1. Claimant identification

First name

Last name

ID number

Email *

Address

Phone

Are you a minor? *

No Yes

2. Service identification

Acquired service *

Amount of the claim or complaint in USD *

Description of the acquired service *

3. Detail of the claim or complaint

Claim or complaint *

Claim Complaint

Detail of the claim or complaint *

Request *