Wniosek o przeliczenie opłat za ogrzewanie

To [Heating company name]
                                                  [Address]

                                                  from [Full name]
                                                  Address: [Address]
                                                  Phone: [Phone]
                                                  Account No.: [Number]

                                      REQUEST
                    to recalculate heating service charges

Please recalculate charges for heating service.

Period: [specify period].
Reason: [specify reason].




Please inform me about the results according to the established procedure.

12/04/2026                                                         _______________
                                                                       (signature)