Customer Complaint Form

Name of natural person, surname/name of legal person

Personal number of the natural person/registration code of the legal person

Registered address of natural person/official address of registration of legal entity

Phone number, E-mail address

Date, location

Please specify the type of product/service that is the subject of the complaint.

Please provide the reason and detailed details of the situation complained of and other relevant information, i.e. documents proving If the complaint is related to a specific contract, violation of the contract concluded with the Bank, date and number etc.

Please make clear, precise and motivating claims.

Name, surname of the person/representative

I agree that EMBank will process the data included in this form to contact me and register the application.*