Customer Complaint Form

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Authorization *

I hereby authorize Philippine Business Bank to collect and process the data indicated herein for the purpose of improving the customer service interaction of the Bank. I understand that my personal information is protected by RA 10173, Data Privacy Act of 2012.

Required

Complete Name: *

Home Address: *

Landline Number/ Cellphone Number: *

Email Address:

Date Occurred: *

YYYY

Branch/Unit Involved: *

Branch Personnel Involved: *

Description of the Complaint (Please type a clear description of the complaint.) *

Declaration *

I hereby declare that the information given in this form is true and correct to the best of my knowledge and belief. In case any information given in this form proves to be false or incorrect, I shall be responsible for the consequences.

Required

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