Public Complaint Form

Aduan System > Public Complaint Form

Name:

I.C/Passport No.

Address:

Happening Place/District:

Telephone No.:

Fax No.:

E-Mail:

Client Category:

Gender:

Age:

Race:

Nationality:

Complained Department:(Please choose Lain-lain for privatised govt. agency)

Name of Complained Privatised govt. agency:

Any resolution efforts made?

If there are, please enter name of contacted officer or department

Complaint Title:

Complaint Info:

Upload Images:

Imej (Image) 1: Imej (Image) 2: Imej (Image) 3:

Recognition
I certify that I have read and understand definition of complaint and complaint management procedures by BPANS (JKM). All personal information and the information given by me is true and I am responsible for it.

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