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Customer Complaint Submission Form
Inquiry or Complaint
Type of Submission
*
Inquiry
Complaint
Date Filed
Complainant Information
Name
Enter the complete name of the complainant.
Company (If applicable)
Provide the name of the company if filing on behalf of the organization.
Address
Enter the full address of the complainant.
Email Address
Provide a valid email address for communication.
Contact Number
Enter a mobile or landline number where you can be reached.
Complaint Information
Type of Complaint
Construction Deficiency
Against (Contractor or Entity)
PCAB License No. (if applicable)
Address
Details of Complaint
Project Title
provide the title or name of the project related to the complaint.
Project Location
Specify the location where the project is or was conducted.
Brief Description of the Complaint
Describe the issue in detail including relevant facts and circumstances.
Date of Incident
Enter the date when the incident or issue occurred.
Supporting Documents (Optional)
Upload any supporting documents related to the complaint (recommended).
Request Action
State what resolution, response, or action you are seeking regarding your complaint.
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