Submission of the complaint

(to be sent by the client to the crowdfunding service provider)

1.a Personal data of the complaintant

1.b Contact details (if different from 1.a)

2.a Personal data of the legal representative (if applicable) (a power of attorney or other official document as proof of the appointment of the representative)

3. Information about the complaint

Complainant / Legal representative

Documentation provided (please upload the appropriate document):