Kupczyk - Repair or Preventive Maintenance Request Form

Repair or Preventive Maintenance Request Form

Request Category Select *

Personal information Submitted by (Full Name) * Phone Number * Email Address *

Device Information Date of Purchase * Device Model * Device Usage Location Description of the Issue *

Information Clause (GDPR) * By submitting the form, you consent to the processing of your personal data by KUPCZYK Sp. z o.o., with its registered office at ul. Grabska 25, 32-005 Niepołomice, for the purpose of handling the service request, in accordance with Article 6(1)(b) and (f) of Regulation (EU) 2016/679 (GDPR). You have the right to access your data, rectify it, erase it, restrict its processing, object to its processing, and lodge a complaint with a supervisory authority. Providing your data is voluntary, but necessary to process your request.

* required fields

If you encounter any issues, please report faults via email or phone:

phone: 697 887 277

E-mail: serwis@kupczyk.pl