Complaints Form Consumer Information FormConsumer InformationName/Contact *E-Mail *Phone (Day Time) *Phone (Alternative) Customer/Organisation (If different from Name/Contact) Mailing AddressStreet Village Town Service Address(If different from Mailing Address)Street Village Town Service Provider InformationService Provider Service Provider Account No Nature of Complaint Have you reported this complaint to the Service Provider? YesService Provider Complaint ID Please Note RIC can only process complaints that have been first filed with the Service Provider as specified in section 53:4 of the RIC Act.When was the report made?Date (if you cannot specify) 1 - 3 Months4 - 6 Months7 - 9 Months10 - 12 MonthsOver A YearHave you reported this complaint to any of the following? Member of ParliamentMinistry of Consumer AffairsRelevant MinistriesOffice of the Ombudsman VerificationPlease enter any two digits *Example: 12This box is for spam protection - <strong>please leave it blank</strong>: