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Republic of the Philippines RO7-SF004-COMP

DEPARTMENT OF TRADE AND INDUSTRY – REGION 7 Rev: 0


8 Sept 2009
Regional Office

REF. NO._____
CONSUMER COMPLAINT
THE UNDERSIGNED COMPLAINANT/S, TO THIS HONORABLE OFFICE MOST RESPECTFULLY
ALLEGE/S THAT:

1. NAME/S OF COMPLAINANT/S: AGE ______ STATUS ________ CONTACT


NO._____________
___________Lorna Mae Baviera__________________________________________________
___________Maria Ludica Oja___________________________________________________

2. ADDRESS: ________NHA Kauswagan, Cagayan De Oro City______________________________


___________________________________________________________________________

3. NAME/S RESPONDENT/S: CONTACT NO._856 7999, 72 7999 __________


_______ Oro Graphics Inc. ___________________________________________
____________________________________________________________________________

4. ADDRESS: ________ Captain Vicente Roa Extension, Cagayan de Oro City __________________________
____________________________________________________________________________

5. OWNER/MANAGER: _____________________________________________________________________
6. CAUSE/S OF ACTION:
() Violation of the Consumer Act of the Philippines (RA 7394) more particularly:
(X) Provision on Deceptive, Unfair and Unconscionable Sales Act or Practice
(X) Provisions on Consumer Product and Services Warranties / Guaranty
( ) Provisions on Labeling and Fair Packaging
( ) Provisions on Advertising and Sales Promotion
( ) Other Provisions contained therein specifically:
__________________________________________________________________________________
() Violation of Republic Act No. 71, as amended (Price Tag Law)
() Other Fair Trade Laws
Specify: _____________________________________________________________________________

7. STATEMENT OF ULTIMATE / RELEVANT FACTS (DATES, PERSONS, SITUATIONS, WITNESSES, ETC.)

____See attached Letter


Complaint____________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________
(PLS. USE ANOTHER SHEET/S, IF NECESSARY.)

8. PROOFS/EVIDENCES: (Photocopies of O.R., Sales Invoice, Warranty Card, Job Order, etc)

MARKED AS ANNEX:
_____Annex 1 Sales Invoice_________ _____Annex 3 Apple Service Provider Report____
_____Annex 2 Apple Online Warranty__ _____Annex 4 Photograph of the Marking ________

9. RELIEF COMPLAINANT/S PRAY FOR THE FOLLOWING:


( ) Repair
(X) Replacement
( ) Refund
Others: (pls. specify)
___cost of shipping courier from cebu to cagayan
__________________________

IN WITNESS WHEREOF, I have hereunto set my hand this ______day of _______________, 200__
in _______________________________________________.

_________________________
COMPLAINANT/S

VERTIFICATION/CERTIFICATION OF NON-FORUM SHOPPING

THE COMPLAINANT/S, UNDER OATH, HEREBY DEPOSE/S AND SAY/S:


A) That he/she/they is/are the complainant/s in the instant case;
B) That he/she/they has/have read and understood the contents thereof;
C) That the allegations therein are true and correct of his/her/their own personal knowledge and
belief;
D) That further, he/she/ they certify that as of this date, he/she/they/has/have not filed in any court,
tribunal or quasi-judicial agency, other action/s or claims involving the same parties and the same
issues. Should he/she/they find/s thereafter that a similar action or claim is filed or pending in any
other for a, he/she/they shall report the same within five (5) days therefrom to this honorable
office.

___________________________
COMPLAINANT/S

SUBSCRIBED AND SWORN TO this _____________ day of ____________ affiant/s having exhibited to
me his/her/their community tax certificates/tin, passport, company ID as follows.

NAME CTC/PASSPORT/ETC
_____________________________ ___________________________________
_____________________________ ___________________________________

___________________________
ADMINISTERING OFFICER

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