Protecting the health and safety of consumers

 Union actions in the field of public health and tobacco

 Food products
 The drugs
 The general product security system and market surveillance
 The safety of cosmetic products, explosives for civil use and toys
 Affordable communications for businesses and consumers

The protection of the economic interests of consumers

 Services of the information society, electronic commerce and electronic and cross-
border payments
 Television without borders
 Distance sales contracts and contracts negotiated outside commercial establishments,
the sale of goods and guarantees, and abusive clauses in contracts
 Unfair business practices and misleading and comparative advertising
 Liability for damage caused by defective products and price indication
 Consumer credit and mortgage credit
 Combined trips and time-share properties
 Air transport
 Energy markets
 The Network of European Consumer Centers (CEC Network or Eurowindows) and the
Your Europe portal

The protection of the legal interests of consumers

The protection of the legal interests of consumers

Measures applied after the outbreak of COVID-19

COMPLAINTS AND CLAIMS SHEET

PHYSICAL PERSONS:
Name and surname:________________________________________________ I.D:
________________
Domicile: __________________________________________ Population :
__________________________
Province : _________________________________________ C.P: _________
Telephone:_______________

In case of representation:
Name and Surname of the represented person:
_______________________________________________
The representative does so as:
______________________________________________________

LEGAL PERSONS:
Business
name:_______________________________________________________________________
____
C.I.F: ________________ Domicile:
_______________________________________________________
Population : _______________________________ Province : ______________________ C.P:
__________ Telephone:_____________ Data from the public registry of the entity:
_________________________________

Details of the person submitting the complaint or claim:

Name and
surname:_____________________________________________________________________
_
I.D: ______________________ Acts as: __________________________________________

IDENTIFICATION OF THE DEPARTMENT OR OFFICE TO WHICH THE COMPLAINT

REFERS:
Name of the Society:__________________________________ Department:
____________________

COMPLAINT OR CLAIM:
Describe the facts and reasons for the complaint or claim filed with the company's Customer
Service Department:
____________________________________________________________________________
____________________________________________________________________________
____________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
________________________________________

REQUEST MADE TO THE COMPANY:

Describe the request you make to the Company in relation to the facts described above:

____________________________________________________________________________
____________________________________________________________________________
____________________

I hereby declare that I am not aware that the subject matter of the complaint or claim is being substantiated through an
administrative, arbitration or judicial procedure.
I expressly accept the inclusion of the data provided in this form, as well as those derived from the processing of my file, in the
automated file of personal data whose owner is Cevs Gestión de Redes, SL located at Calle López de Hoyos 190 of Madrid with
postal code 28002. The inclusion of my data in said file will have the sole purpose of processing my complaint or claim before
the Insurance Company or Brokerage according to the provisions of the Ministerial Order Eco/734/2004, at any time I will be
able to exercise my right of access, rectification or cancellation of data and opposition, whenever pertinent, as well as the
revocation of consent for the transfer of my data or for any of the aforementioned uses.

In compliance with current legislation, I have been informed in the event that my complaint or claim reaches the Commissioner
for the Defense of the Insured and the Participant in Pension Plans, Cevs Gestión de Redes S:l is legally obliged to report the
data (including personal) to this figure of the General Directorate of Insurance and Pension Funds so that it can process my file.
In __________ a __________ the __________________the 2.00__

Claimant Signature: