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Product name (e.g. Spinach Mini Burger)* Production batch* Expiration date / Best before (dd/mm/yyyyy)* Is it possible to pick up the product?*

Please provide an attachment with your product that makes clear the nature of the complaint*

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Address (indicate street, house number, postal code, city and province)*

I declare that I have read and fully understood the privacy policy relating to the processing of my personal data provided to me by the Data Controller. I also declare that I am aware of the responsibilities and sanctions established by law for false communications/statements. In this sense, I exempt the data controller from any responsibility regarding the correctness of the data entered above.*

I don't agreeI agree

to the processing of my personal data for the sending of newsletters and other informative material as well as for promotional and/or marketing purposes referred to in point 2, subpoint 3, of the privacy information in the manner indicated therein.*

I don't agreeI agree

to the processing of my personal data to analyze my preferences and receive information and/or personalized commercial communications, referred to in point 2, subpoint 4, of the privacy policy and to improve the quality of the products and services provided.*