Have you complained to the company or individual? Have you followed it up with a complaint letter? You must do so before filing this complaint and send it to your Provincial Consumer Office. Keep a copy of this document for future reference (contact numbers in section 2 Consumer Organisations) Please type or print clearly in dark ink.

Download Complaint Form here

COMPLAINT FORM

THE COMPLAINANT (Person making the complain)

Surname………………………………………………………..Initials……………………………….

Home Address…………………………………………………………………………………………………..

Street name and number……………………………………………………………………………………

City …………………………………………………………….Code…………………………..

Province ………………………………………………………………………………………………………….

Business or Postal address:………………………………………………………………………………..

Street…………………………..City………………………….Code……………………………………..

Province…………………………………………………………………………………………………………..

Home telephone number (code) ……. ………………Fax (code)………………………………

Work telephone number (code)………………Fax (code)………………………………………

Cell number ……………………………… email address…………………………………………….

Type of complaint (eg automobile, home improvements, etc)………………………………..

……………………………………………………………………………………………………………………….

Date of transaction …………………………………………………………………………………………..

Cost of product and/or service ………………………………………………………………………….

Complaint against : (if more than one firm and/or address, include all) …………………

……………………………………………………………………………………………………………………….

FIRM/COMPANY COMPLAINING TO

Person, company, or firm (if more than one, include all; use name given in telephone directory if possible.

……………………………………………………………………………………………………………………….

Name/s of salesperson/s or representative/s you dealt with……………………………………

……………………………………………………………………………………………………………………….

……………………………………………………………………………………………………………………….

Date of complaint to company………………………………………………………………………….

Address…………………………………………………………………………………………………..

Street name and number……………………………………………………………………………………

City…………………………………….Code………..   Province……………………………….

Telephone number   (code)………………Fax (code)………………………………………………

email address…………………………………………………………………………………………………..

Person contacted……………………………………………………………………………………………..

By phone/letter/in person……………………………………………………………………………………

Result of contact……………………………………………………………………………………………….

……………………………………………………………………………………………………………………….

……………………………………………………………………………………………………………………….

……………………………………………………………………………………………………………………….

FURTHER INFORMATION (if applicable)

……………………………………………………………………………………………………………………….

……………………………………………………………………………………………………………………….

……………………………………………………………………………………………………………………….

……………………………………………………………………………………………………………………….

……………………………………………………………………………………………………………………….

MANUFACTURER OF PRODUCTS

Name………………………………………………………………………………………………………………

Address…………………………………………………………………………………………………………….

Product model or serial number………………………………………………………………………….

Warranty expiry date………………………………………………………………………………………….

Events in the order they occurred, as concisely as possible (use extra paper if necessary

……………………………………………………………………………………………………………………….

Form of resolution sought( e.g exchange, repair, money back)………………………………

……………………………………………………………………………………………………………………….

 

Herewith attached photocopies of any papers involved (contracts, warranties, bills, received, cancelled cheques, correspondence, etc) Do not send originals.

I hereby give permission to release a copy of this complaint to the business involved, and to any law enforcement agency, as necessary.

The information contained in this form is true, correct and complete to the best of my knowledge.

 

Signature …………………………………….. Date…………………………………………………

Download Complaint Form here