CONSUMER FORMS

CONSUMER COMPLAINT FORM

In terms of Regulation 4 of the Regulations Regarding Consumer Complaints, consumer Complaints must be submitted on this form, after the Respondent has been given fourteen (14) days to first resolve the matter.

Was this complaint first submitted to the Respondent?

If yes, what date was it submitted to the Respondent?

If no, first submit a complaint to the Respondent and allow the Respondent fourteen (14) days to resolve the matter, alternatively provide a clear and concise statement of the reason why the complaint was not first submitted to the Respondent.

A. COMPLAINANT

Complainant

Physical Address

Postal Address

Telephone number(s)

Facsimile number(s)

Electronic mail address(es)

B. CONTACT PERSON (IF DIFFERENT FROM COMPLAINANT)

Contact Person

Physical Address

Postal Address

Telephone number(s)

Facsimile number(s)

Electronic mail address(es)

C. RESPONDENT

Contact Person

D. COMPLAINT

Provide an accurate and concise statement of the facts illustrating the Complaint and demonstrating that the Respondent acted wrongly.

E. RELIEF SOUGHT

Provide a clear and concise statement of the specific relief or remedy sought.

F. ANY OTHER INFORMATION

Provide any other relevant information



The applicant warrants that the information provided herein is true and correct.
Yes

No.Consumer Complaint Form 
1In terms of Regulation 4 of the Regulations Regarding Consumer Complaints, consumer Complaints must be submitted on this formDownload

REPORT FORM

No.Report Form 
1In terms of Regulation 4(3) of the Regulations Regarding Consumer Complaints, licensees and persons providing services without a licence must maintain records of all complaints and provide an annual report to the Authority on this form: Download

REQUEST FOR ADJUDICATION FORM

No.Request for Adjudication Form 
1Request for Adjudication Form (Regulation 4 [2])Download

RECONSIDERATION FORM

No.Reconsideration Form 
1Form D -ReconsiderationDownload