Please complete this form to lodge your complaint to the CBE. Should you need assistance to complete the form, kindly contact the Legal Department on (012) 346 3985 or email firstname.lastname@example.org
All fields marked with * are compulsory.
Alternative Contact No.
Are you complaining in your personal capacity or acting on behalf of another person or organisation?
---Personal capacityOther person/organisation
If acting on behalf of another person or organisation, please provide details
Name of person or body against whom the complaint is lodged (Respondent)
Respondent’s email address (if applicable/known)
Nature of the relationship between the complainant and the respondent*
Nature of Complaint *
Have you previously lodged a complaint against the respondent for the same matter?*
If a reference number was provided, please specify
The relevant date(s) on which the events occurred*
The place where the events occurred
Description of Complaint
What are you not happy with?*
Please attach any documents that you think will assist in resolving your complaint (Max size per file: 3MB)
What outcome do you desire?*
Please note that any personal information that you have or may disclose to or share with the CBE in this form or pursuant to anything advertised or otherwise published by the CBE may be processed in terms of the Protection of Personal Information Act, No.4 of 2013 and Regulations promulgated thereunder (“POPI Act”). By disclosing or sharing your personal information, you are unconditionally consenting to the processing by the CBE, its stakeholders or partners of your personal information. Further, you declare that you have obtained all consents required by the POPI Act or any other law applicable in respect of all personal information you disclose. Thus, you hereby indemnify the CBE against any civil or criminal action, administrative fine or other penalty or loss that may arise as a result of processing any personal information that you disclose to the CBE. Should you wish to object to the processing of any of your personal information as aforesaid, please do so in writing to the email addresses provided above at any time. The CBE undertakes to process your personal information only as required by law and within the bounds of the POPI Act.
I have read and hereby agree to the declaration and disclaimer above.