UCAA Consumer Protection Complaint Form

1. Personal Information

Name *

Physical Address

Phone Number *

Email *

a. Reference Number

b. Ticket Number

c. Flight Number

Departure Date

Arrival Date

Point of Embarkation

Point of Disembarkation

2. Summary of the Complaint

Your Complaint is Against? *

Specify Service Provider *

Type of Complaint *

Date and Time of Incident

Complaint Details *

3. Service Provider Details

Have you contacted the Service Provider(s) in Question 2 above? *

Yes No

a. Name of Service Provider Staff

b. E-mail

c. Telephone Contact

d. Date(s) of Contact(s)

Attach evidence of correspondence(s) between the Service Provider and the Complainant

Accepted formats: PDF, DOC, DOCX, XLS, XLSX, JPG, JPEG, PNG.
Maximum file size: 10MB per file.

4. What Results (Outcomes) Do You Expect?

Expected Outcome *

Signature of Complainant *

Date