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1. What name of the company do you want to complain about?
2. What is the address of the company?
3. What name of the employee do you want to complain about?
4. When did you purchase the product?
5. Where was the store located you visited? (Add Full address)
6. What is your name?
7. How to contact you? (insert phone no./email)
8. What's today's date?