Complaints Form

IB products s.r.o. | E-shop: molequa.com Bratislava, Slovensko – Slovakia Company ID: 55 336 809 | Tax ID: 2121954483 | VAT ID: SK2121954483 E-mail: info@molequa.com

1. Customer Details

2. Details of the Claimed Goods

3. Description of the Defect

Type of defect (mark with a cross):

• apparent defect – identified upon receipt (packaging defects, quantity, identification)
• latent defect – identified subsequently during use/analysis (purity, identity of the substance, stability)
• quantitative discrepancy
• damage during transport (attach the carrier’s protocol)
• other: ____________________________________

Date of identification of the defect: _______________

Detailed description of the defect (what, when, how and under which conditions it was identified):

Storage conditions from receipt until identification of the defect (temperature, humidity, light):

4. Annexes

Please attach (mark as applicable):

• photographic documentation of the defect
• copy of the invoice / delivery note
• carrier’s damage protocol (where damage occurred during transport)
• result of the Customer’s own analysis of the Goods (if available)
• other: ____________________________________

5. Requested Method of Settling the Complaint

Indicate the preferred method (the decision on the method of settlement rests with the Company pursuant to Clause 9.5 of the GTC):

• supply of replacement Goods
• supply of missing Goods / quantity adjustment
• grant of a reasonable discount from the Price
• other: ____________________________________

6. Declaration of the Customer

The Customer declares that:

• the information provided in this protocol is true, complete and correct;
• the Goods have been stored and used in accordance with the manufacturer’s instructions and the conditions stated on the packaging;
• the Goods were not used for any purpose other than scientific research and development (in particular, they were not used as a medicinal product, food supplement, cosmetic product or in sport);
• the Goods were not mechanically damaged, modified or otherwise impaired by the Customer;
• the Customer acknowledges that the Goods must not be returned to the Company without express instructions (Clause 9.4 of the GTC); otherwise the Customer shall be liable for any resulting damage;
• the Customer acknowledges that, in the case of an unjustified complaint, it shall be obliged to reimburse the Company’s costs (Clause 9.6 of the GTC).

In ___________________ on _______________

Signature (authorised representative of the Customer): _______________________

Instructions for the Customer

1. The completed and signed protocol shall be sent:

• by e-mail (scan / photograph): info@molequa.com, or
• by post: IB products s.r.o., Bratislava, Slovensko, Slovakia.

2. Do not return the Goods without prior instructions from the Company. Upon review of the complaint, we will contact you with further instructions.

3. Time limits for asserting defects:

• apparent and quantitative defects: within 2 business days of receipt;
• latent defects: within 1 month of delivery of the Goods.

4. We shall settle the complaint within a reasonable period and inform you of the method of settlement by e-mail.

To Be Completed by the Company