Fill out the below form to register a complaint. A non-refundable amount of Rs 1000/- is to be deposited for registering a complaint.

Fill in the form below:

*All fields are mandatory

Name

E-mail

Phone

Organisation

State ---Select State--- Andaman and Nicobar Arunachal Pradesh Andhra Pradesh Assam Bihar Chandigarh Chhattisgarh Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Ladakh Maharashtra Manipur Meghalaya Mizoram Mizoram Odisha Pondicherry Punjab Rajasthan Sikkim Tamil Nadu Tripura UT of DNH and DD Uttarakhand Uttar Pradesh West Bengal

City

Address

Pin Code

Complaint

Upload Supporting Documents Please upload in .doc, .docx .xlsx, .xls, pdf, jpg, png formats (per file size within 2MB).

I hereby declare that the above information is true & correct to the best of my knowledge and belief.

Change Image

Enter Displayed Text (Please key in the above code as it appears in the box.)