THE CIVIL AVIATION (PROCEDURES FOR COMPLAINTS HANDLING) RULES, 2008
Made under r. 9(3)
COMPLAINT FORM
For Authority’s Use Only
Complaint No…..of……..
____________________________________vs._______________________________
Complainant Respondent
USE CAPITAL LETTERS TO PRINT
USE A SEPARATE SHEET IF NECESSARY
A: PARTICULARS
EITHER
Physical Person:
Name of Complainant (surname, first name):
__________________________________________________________Sex:_______________
Address: _____________________________________________________________________
_____________________________________________________________________________
Profession: ____________________________________________________________________
_____________________________________________________________________________
Nationality: ___________________________________________________________________
Date of birth: _________________________________________________________
OR
Legal Person:
Name of Complainant: __________________________________________________________
_____________________________________________________________________________
Status (e.g. limited liability company/body corporate/association etc)_______________________
_____________________________________________________________________________
Physical Address: ______________________________________________________________
_____________________________________________________________________________
Who is representing: _____________________________________________________________
_____________________________________________________________________________
Name of the person signing the complaint and his status: ________________________________
_____________________________________________________________________________
Name of the respondent: ________________________________________________________
_____________________________________________________________________________
Address: _____________________________________________________________________
Occupation: __________________________________________________________________
B: NATURE/FACTS OF THE COMPLAINT
(State the complete description of the complaint precisely and concisely; include copies of all
relevant documents)
______________________________________________________________________________________
______________________________________________________________________________________
___________________________________________________________
If known, the reference to specific laws, regulation, concession contracts, licences, codes or norms
which were supposedly infringed.
______________________________________________________________________________________
______________________________________________________________________________________
___________________________________________________________
C: EVIDENCE THAT THE COMPLAINANT HAS SUBMITTED THE COMPLAINT TO THE
REGULATED SUPPLIER AND THAT AVENUES WHICH COULD SOLVE THE PROBLEM
WERE EXHAUSTED ACCORDING TO THE REGULATED SUPPLIER’S PROCEDURES
______________________________________________________________________________________
______________________________________________________________________________________
___________________________________________________________
D: DESCRIPTION OF THE RESPONSE OR REMEDY WHICH THE REGULATED
SUPPLIER IN QUESTION HAS MADE OR OFFERED
______________________________________________________________________________________
______________________________________________________________________________________
___________________________________________________________
E: DESCRIPTION OF THE REMEDY OR REMEDIES DESIRED
______________________________________________________________________________________
______________________________________________________________________________________
___________________________________________________________
F: I hereby declare that all the facts and information given in the application are correct
to the best of my knowledge.
Presented for filing this _____________ day of _______________________ year ___________
________________________________
SIGNATURE OF THE COMPLAINT(S)
For Registrar’s Use Only
Date Received:__________________ File No.________________________________
Date Resolved:_________________________________________________________