Formulario de Reclamo

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Tipo de persona

Natural Juridica

Nombres y Apellidos

No. identidad/pasaporte

Dirección

Departamento

Municipio

Teléfono

Celular

En caso de representación

Representante legal

No. identidad/pasaporte

Razon social

Correo electrónico del cliente

RTN

Domicilio legal

Municipio

Departamento

Telefono

Celular

Nombre Representante legal

DNI/Pasaporte

Fecha del reclamo

Reclamación

¿Provee documentación que respalde el reclamo?

SI NO

En caso afirmativo:

¿El reclamo es reiteración de un reclamo anterior?

SI NO

En caso afirmativo:

PETICIÓN QUE REALIZA ANTE LA CNBS:

Describa la petición que realiza a la Comisión Nacional de Bancos y Seguros en relación a los hechos anteriormente descritos

En caso que el usuario financiero haya presentado su reclamo de manera paralela en otra instancia administrativa o judicial, sería de enorme provecho para la investigación que usted solicita, que la CNBS conozca de tal acción.

En caso de ser afirmativo, por favor indicar la instancia y la fecha que la interpuso.