[EbGeeze]

Please complete the relevant information below. Sign and date a printed copy of the document by hand. This copy
should be forwarded to customercare@mytheresa.com, as well as images of the packaging (full view of the interior and
exterior, with all labels visible), if applicable.
First and surname of recipient: ____________________________________________________________________
(as printed on passport/personal identification)
Delivery address of recipient: _____________________________________________________________________
_____________________________________________________________________________________________
Order number: ________________________________________________________________________________
Tracking number (UPS/DHL): _____________________________________________________________________
Reason of the complaint (please select):
 Non-receipt of shipment:
I hereby confirm that I have not received my above-mentioned order at the delivery address indicated.
(If applicable) I also confirm that I do not recognize the name or signature on the proof of delivery provided by the
courier.
Further notes (if desired): _____________________________________________________________________
 Parcel delivered – content damaged:
Please keep all packaging at the given delivery address in the condition that it was received.
Describe damage: ___________________________________________________________________________
__________________________________________________________________________________________
 Parcel delivered – content missing:
Please keep all packaging at the given delivery address in the condition that it was received.
Item number(s) of missing item(s): (P00…) ________________________________________________

Item number(s) of item(s) received: (P00…) ________________________________________________
Describe damage: ___________________________________________________________________________
__________________________________________________________________________________________




(Signature) _______________________________________ (Date) __ __ / __ __ /