TISSC reference number: (Office Use Only)
When you lodge a complaint, please complete and return to us by mail or fax, a signed copy of this Personal Details Complaint Form
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I consent to TISSC providing my personal details, ie. name, address and telephone number, to the Service Provider(s) about whose service(s) I am complaining, for the purposes of dealing with the complaint. |
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| My details are (please print): | ||
| Name: | ||
| Address: | ||
| Telephone number (including area code): |
(h) (w) (mob).............................................. |
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| Fax number (including area code): | ||
| Email: | ||
| Bill Carrier/Account number: |
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| 190 number/s complained about: |
.... |
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. (Signature) |
..../..../.... (Date) |
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You can contact TISSC on our consumer line 1300 139 955 to check on the progress of your complaint, and on your personal information held by 190 Complaints.