I declare that all the information provided above is accurate and based on facts, and I take full responsibility in case proven otherwise. I also declare that the complaint is not presented in front of the court, and that I will not take any other action in case I agree with the bank to correct the complaint and the bank acts accordingly.

I declare that I received a copy of this form.

 General Notes:

1. The Bank will get back to the customer within 15 working days from the day the complaint was received.
2. The customer should complete all the fields in the form, including the authorized signature by the bank, whether the complaint was submitted personally or by email.
3. Submitting the complaint is to be done through filling the complaint form, otherwise the complaint may not be attended to by the Bank.