Complaint Form - fpb Complaints

ID No.

Name and Surname

Gender

MaleFemale

Race

Residential Address

Postal Address

Telephone No

Cell No

Email Address

Are you submitting for behalf of someone or an organization? YesNo

Date

Is it still happening?

YesNo

Where did it happen?

PhysicalOnLine

Please provide the location

Please provide the online Link (URL)

If you know, which section/s of the FPB Act was or were contravened

If you know, the full name(s) and surname(s) of person(s), association, organisation or organ of state who contravened the sections of the Act, please tell us

If you do not know his / her / its / their names, please tell us anything you do know about him / her / it / them

Did anybody see or hear what happened (only people who actually saw or heard what happened, not people who heard about it from someone else)?

In your own words, tell us exactly what happened (include all information but be as brief as possible)

Have you reported the matter to anyone else? If yes, please tell us who you have reported the contravention to

Were any steps taken by the person / association / organisation / organ of state to resolve the matter?

What outcome do you propose or expect from this complaint (tell us what you would like to achieve with this complaint and the relief sought)?

Do you need an interpreter when attending any investigations at our offices? If yes, please tell us the language you speak YesNo

Can we use your name in news reports or letters we write regarding this matter / complaint? YesNo

Please tell us how you heard about the Film and Publication Board (e.g. radio advert, newspaper, poster, from a friend, etc.)

I am the individual responsible for making this electronic submission or have been duly authorized by the appropriate party to submit this information. I have personally reviewed the information contained within this submission, and to the best of my knowledge, understanding, and belief, confirm that it is true, accurate, and complete. I understand that providing false or misleading information in this submission may result in legal consequences, penalties, or other actions as deemed appropriate by the receiving party. I acknowledge my responsibility to promptly update or correct any information in this submission should I become aware of any inaccuracies or changes that may affect its truthfulness or completeness. I understand that this electronic declaration holds the same legal standing and implications as a signed written declaration. By submitting this electronic form, I hereby affirm the above declaration and take full responsibility for the content and veracity of the information contained within

I Accept terms and condition

Disclaimer: FPB will assess your report according to the law in our country and if is illegal the location of the reported material will be passed to the police and if it is overseas, we will forward it to the relevant INHOPE hotline

FPB Complaint Form