CUEA CUSTOMER COMPLAINT FORM

Section A: CUSTOMER DETAILS	Date: …………………………

Customer’s Name:
Organization / Department:	Reg. No:
Address:
Telephone (Office) :	Mobile:
Emails:

Section B: *COMPLAINT DETAILS

Action Taken:
Received by:
Department :	Date:	Signature:

Section C: RECEIVED BY MR

Forwarded to HOF for Remedial Action:
Yes	Head of Function:
No	Reason:
Signature:	Date:

Section D: DEPARTMENT (to be filled by HOF)

Department:
Target Date of Completion:
HOD’s Signature:	Date:

… /2

Section E: CORRECTION TAKEN (to be filled by HOD)

Section F: *CORRECTIVE ACTION TAKEN (to be filled by HOD)

HOD’s Signature:	Date:

Section G: *FOLLOW UP BY CCM

Signature:	Date:

Section H: *COMPLAINT SIGNED OFF BY MR

Signature:	Date:

NB:	1.	On completion of Section A and B, kindly forward to the MR Office

2.	All sections with an asterix (*) must be completed

3.	Form to be submitted to the MR’s Office within 24 hours of complaint receipt.

4.	Kindly attach any documentation related to the complaint if available.