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Privacy Complaint Form 

Privacy Complaint Form

Complainant Details

Name
Name
First
Last
Telephone
NOTE: Please submit proof of authorization with this form (e.g. Power of Attorney)

Jamaica National Member Company Information

Details of the Complaint

Please indicate how you believe your privacy has been breached.

(Please provide sufficient details to enable the Company to appropriately investigate your complaint e.g. what happened, when and where it happened, who was involved, how you believe your personal data has been mishandled)
Note: It may be necessary for the Company to contact any third parties named in the complaint which may necessitate disclosing your identity and the nature of your complaint. If you advise the Company that you do not wish for it to do so, that may mean that the Company cannot properly investigate and resolve your privacy complaint.
Do you consent to the Company contacting the third party named above?
Please attached a copy of your Photo ID along with any documents you consider may assist the Company’s investigation of your privacy complaint.

Maximum file size: 1MB

Maximum file size: 1MB

Accept*
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