Complaint form

1) Details of Complainant

Name of Person/Firm

BRN (If applicable)

Person to be contacted (If different from above)

Phone

Address

Address Site Location (If different from above)

2) Details against whom Complaint is made

Name of Person/Firm

BRN (If applicable)

Address

Phone

Details of Complaint

Date of Occurrence

Description

Expectation

Site Visit Requested ?

Yes No

Has a complaint been filed at other authorities (e.g. The Police, etc)

Yes No

If yes, please provide details:

Attachments

CIA Registration Certificate (if any)

Approved Drawings

Letter of Award

Report from Registered Professional(s)

Building & Land Use Permit (BLUP)

Contract / Agreement

Photo(s) taken on site