Data of the complainant: (*) All data are mandatory

Nome:

Cognome:

Business name:(If it is not a natural person)

Indirizzo:

CAP:

Città:

Paese:

Email:

Telefono:

User's Data (if different from the person submitting the complaint) and any other passengers

Nome Cognome Utente 1:

Nome Cognome Utente 2:

Nome Cognome Utente 3:

NomeU4 Cognome Utente 4:

Trip details

Travel agent / tour operator / ticket seller (if relevant):

Booking code / ticket number:

Departure station / stop:

Arrival station / stop:

Scheduled Date and Time:

Effective Date and Time(where it does not coincide with the scheduled time):

Line (if rivelant):

Reasons for the complaint for regular services of a distance equal to or greater than 250 km. Please indicate a sign of
tick next to the relevant items (*)

Ticket issuance / Contractual conditions or discriminatory ratesRights of people with disabilities or reduced mobilityInformation in case of cancellation or delay in departureAssistance at the station in case of cancellation or delay at departureAlternative transportation or refund in case of cancellation, delay in departure or overbookingTravel informationInformation on passenger rightsDifficulty in filing the complaint

Other:

Select how you want to receive compensation / refund if due:
Coupons or other services

Reasons for the complaint for regular services of a distance of less than 250 km. Please indicate a check mark
next to the relevant items (*)

Contractual conditions or discriminatory ratesRights of people with disabilities or reduced mobilityTravel informationInformation on passenger rightsDifficulty in filing the complaint

Other:

Select how you want to receive compensation / refund if due:
Coupons or other services

Description. Please describe the incident with regard to all the items for which the check mark has been indicated

Attach documents eg. Proxy and user identity document (in the event that the complaint is presented by a person other than the user)
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