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



    Attach file

    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