FILED BY (fill in your contact details)
Slovenska cesta 1
THE AGENCY’S ADDRESS (the address to which you should send the claim for dispute resolution)
Place and date
Subject: a request for resolving a dispute with operator XY
THE MAIN TEXT OF THE CLAIM (provide as much detail as possible about the issue that you disagree with or the disputed items that you believe the operator unjustly charged to you, and what you demand from the operator)
On 1 January 2008 I concluded a subscription agreement for telephone services at the address Gradnikova cesta 1, Ljubljana, with the operator XY. Due to my having moved on 20 May 2011, I filed with the operator a request for changing the connection location to the address Slovenska cesta 1. The connection was activated at the new address on 31 May 2011.
On 10 June 2011, I received two invoices from the operator XY. On one invoice (no. 001), the operator charged the cost of changing the connection location, the subscription fee for June, and the cost of services used at the address Slovenska cesta 1. I agree with this invoice, I however disagree with the second invoice (no. 002), on which the operator XY charged the subscription fee for June for the address Gradnikova cesta 1. On 15 June 2011 I filed a complaint regarding invoice no. 002 with the operator XY. On 20 June 2011 I received a response that my complaint was unfounded.
Since the operator XY was no longer providing me services at the address Gradnikova cesta 1 after 31 May 2011, the subscription fee for June was charged unfoundedly. I therefore demand that the operator XY writes off this amount.
EVIDENCE (attach all the evidence: invoices, agreements, and all letters exchanged between you and the operator)
request for changing the location of the connection
complaint and the response of the operator XY
SIGNATURE (sign the claim personally)