Online fair trading complaint form : Department of Employment, Economic Development and Innovation

Your details

Title:

*Given name:

*Surname:

*Address:

Home phone:

Fax:

Work phone:

Mobile:

*Email:

Previous complaints

Have you complained in writing to another government agency about this?

No
Yes

If yes, who did you complain to?

Transaction details

Details

Details of your complaint

*Please provide details of the complaint in chronological order:

*What has the trader offered to do to resolve your complaint or what reasons have they given in refusing your request?

*What would you like the trader to do to resolve the matter?

*If we decide that the trader has breached fair trading legislation and the case goes to court, are you prepared to assist us during that process (e.g. as a witness)?

Yes
No

Please note: Most complaints we receive do not proceed to court as they do not involve a breach of legislation. In these instances we will attempt to conciliate the matter with the trader on your behalf to have the matter resolved. See our complaint handling process.

*Are you prepared to be contacted by us in future to help us improve our services?

Yes
No

Demographics

Attachments

Attachments Attach any documents (such as receipts, contracts or warranties) that can be used to support your claim:

Agreement

Agreement If your complaint is resolved after lodgement of this form, please advise us as soon as possible.

I declare that the information supplied by me is, to the best of my knowledge, true and correct. I agree that the information provided (except for demographic data) may, if necessary, be revealed to the trader in correspondence or investigations concerning this complaint or referred to another authority for their appropriate action should the matter fall outside this department's jurisdiction.

I agree (if you do not agree, we will not accept your complaint)