To the Director of Zvonobot CZ LLC
Name/Surname

from the Director of _______________________
___________________________________
____________________________________
(Name of the company, Name/Surname of the Director, physical address)

Claim form

On the date «___» _____________ 202_ between the Zvonobot CZ LLC, represented by ________, acting on_______ and ___________________________, represented by ________________,
                                (Name of the company)                               (Name/Surname of the Juridical person),
acting on _______, was closed a contract №. ___ (hereinafter - contract),
or
On the date «____» ___________ 202_ ________________________, represented by __________________,
                                                                      (Name of the company)                                                (Name/Surname of the Juridical person)
acting on_____________, accepted Terms and Conditions of the Zvonobot CZ LLC Software Product Agreement published on the website ___________________________,

Under which Zvonobot CZ LLC (hereinafter - Rightsholder) undertakes to provide_____________________________
              (To/Name of the company, Name/Surname of the Juridical person)
(hereinafter - the User) a right to use the Rightsholder Software Product,
 located at ______________ (hereinafter – Software product). The User undertakes to pay the granted right of use in the manner and under the conditions agreed by the contracting parties in contract №. --- from «__» ______ 202_ (or in Article 4 of the User Agreement) and in accordance with the tariffs published on _________________, valid at the time of creating and sending the corresponding message packet.
The right to use the Software Product has been fully paid by __________________________________
                                                                                                                                                          ( Name/Surname of the Juridical person)
    (or in amount of _______%, or specify the order of payment for the right to use the Software Product agreed by the parties) ________________________, by the transfer of funds in the way
                                 (date)
    ____________________________, which is confirmed by ___________________________________________________.
(payment method)                                                                                    (proof of payment)
The Rightsholder has not properly fulfilled the obligation set out in Article ____ of the above contract (or in Article __  of the User Agreement), which is confirmed by _______________________________________.
In view of the above, please_______________________________________________ ____________________________________________________________________________________.
(Request to the Rightsholder)

 
Attachment:
A document confirming that the User has fulfilled the obligation to pay for the right to use the Software Product.
Director
___________________                                                                                        _________________/______________
        (Name of the company, Name/Surname of the Juridical person) 

«____» ________________ 202_ г.
                                                                                                                                                                                                                         (date)