MRS OIL NIGERIA PLC
Complaints Management Lodgement Form
SCHEDULE
MRS OIL NIGERIA PLC - COMPLAINT LODGEMENT FORM
1. Complainants Information *
Complainants may be contacted and asked to provide additional information to support their complaint.
2. Personal details *
Title
Required
Surname?
First Name?
Other Names?
3. Contact details
Current contact/mailing address?
Telephone number
Email address
If yes, when:
5. Complaint summary
When did the issue happen?
Where did the issue happen?
Party(ies) involved?
What happened? (kindly give details of your complaint)
How would you like your complaint resolved?
List any documentation you have that supports your complaint (attach copies of the documents to this Form)
4. Complaint details
Have you lodged a complaint regarding this issue before?
6. Acknowledgement by the Complainant
I confirm that the information provided above, is true and correct to the best of my knowledge.
Signature of complainant
Clear selection
MM
/
DD
/
YYYY
Time
:
7. Privacy notice
The information in this form would be used solely for the resolution of your complaint; the company would not provide any access to authorised officers.
8. Office use only
Complaints Officer
Signature
Submit
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