COMPLAINT AGAINST BANK
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Complaint format for Banking Ombudsman
FORMAT
OF
COMPLAINT
TO FILE WITH
THE
BANKING
OMBUDSMAN
(TO
BE FILLED UP BY THE COMPLAINANT)
To:
The Banking
Ombudsman
Place
of
BO’s office…..................................
Dear
Sir,
Sub: Complaint against...............................
(Name
of
the
bank’s
branch)
of
…………………………………………………………………………………(Name
of the Bank)
Details of
the complaint are
as
under:
1.
Name
of the Complainant
…………………..
2.
Full
Address of the
Complainant
……………………
……………………
……………………
Pin Code
………………..
Phone
No/
Fax
No............................................
Email
…………………….
3.
Complaint against
(Name and
full
address
of
the
branch/bank)
………………………….
………………………….
Pin Code...........................................................
Phone
No.
/
Fax
No.
…………………….
4.
Particulars of Bank
or Credit
card Account
(If any)
…………………………………………………………………………
(Please state the number and the nature of account viz. Saving bank/
current/ cash credit/ term
deposit/ loan
account etc.
related to
the subject
matter of the
complaint being made.)
5.
(a)
Date of representation already made by the complainant to the bank
(Please
enclose a copy of
the representation)
……………………….
(b)
Whether
any
reminder was
sent
by
the
complainant?
YES/NO
(Please
enclose
a copy
of
the
reminder
)
……………………….
6.
Subject matter
of the
complaint (Please
refer to
Clause 8 of
the Scheme)
…………………………………………………………………………………………
…………………………
7.
Details of
the complaint:
(If space
is not sufficient, please
enclose separate
sheet)
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
……………………………….........................
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
……………………………….........................
8.
Whether any reply (Within a period of one month after the bank concerned
received the representation)
has been
received from the
bank?
Yes/ No
(
if
yes,
please
enclose a
copy
of
the
reply
)
9.
Nature
of
Relief
sought
from the
Banking
Ombudsman
………………………………………………………………………………
( Please
enclose
a
copy
of
documentary
proof,
if
any,
in
support
of
your
claim
)
10.
Nature and
extent of
monetary loss,
if any,
claimed by
the complainant
by way
of compensation
(please
refer to
clauses 12 (5)
& 12 (6)
of the Scheme)
Rs.……………….
11.
List
of documents enclosed:
(Please
enclose
a
copy
of
all the
documents)
12.
Declaration:
(i)
I/
We, the
complainant/s herein
declare that:
a)
the
information furnished
herein above
is true
and correct;
and
b)
I/We
have not
concealed or
misrepresented any
fact stated
in the
above columns
and in
the documents
submitted herewith.
(ii)
The
complaint is
filed before
expiry of
period of
one year
reckoned in
accordance with
the provisions of
Clause 9(3)(a) and
(b) of
the Scheme.
(iii)
The
subject matter of the present complaint has never been brought before the
Office of the Banking Ombudsman
by me/ us or by any of the parties concerned with the
subject matter
to the
best of
my/ our
knowledge.
(iv)
The
subject matter of the present complaint has not been decided by/pending with
any forum/court/arbitrator.
(v)
I/We
authorise the bank to disclose any such information/ documents furnished by
us to the
Banking Ombudsman
and disclosure
whereof in
the opinion
of the
Banking Ombudsman
is necessary
and is
required for
redressal of our
complaint.
(vi)
I/We
have noted the contents of the Banking Ombudsman Scheme,
2006
Yours
faithfully,
(Signature
of
Complainant)
NOMINATION – (If
the complainant wants to nominate his representative to appear and make
submissions
on
his
behalf
before
the
Banking
Ombudsman
or to the Office of the Banking
Ombudsman,
the
following
declaration
should be submitted.)
I/We
the
above
named
complainant/s
hereby
nominate
Shri/Smt…………………………………………..
who
is
not
an
Advocate
and
whose
address
is
…………………………………………………………………………………………………………………
…………… as
my/our
REPRESENTATIVE
in
all
proceedings
of
this
complaint
and
confirm
that any statement, acceptance or
rejection made by him/her shall be binding on me/us. He/She
has
signed below
in my
presence.
ACCEPTED
(Signature
of
Representative)
(Signature
of
Complainant)
Note:
If
submitted
online,
the
complaint
need
not
be signed.
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International
Consumer Rights Protection Council
