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| Please give the type of product in question? (e.g. wooden train, ironing board, firework) | |
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| Trade name of the product? | |
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| Model marking and year of manufacture of the product? (e.g. VVT 34-789, 2009) | |
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| Manufacturer and/or importer of the product? | |
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| Other spesific information about product? E.g. is the product CE-marked? | |
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| Place and time of purchase? | |
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| Contact details of the place of purchase (address, telephone number): | |
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| Description of the defect of the product or any hazardous situation caused by the product: | |
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| An estimate of the nature of damage or any health hazard, and information about the injured person: | |
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| Contact details: (optional, in case we need to contact you) | |
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| Sender’s name: | |
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| Address: | |
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| Post code and town: | |
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| Telephone: | |
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| E-mail: | |
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| | Documents sent to the authorities are public if they do not contain any trade secrets or information covered by privacy protection. Please enclose your contact details in case we need to request further information. |
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