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Annexure D - POPI Complaint Form

We are committed to safeguarding your privacy and the confidentiality of your personal information and are bound by the Protection of Personal Information Act.

Please submit your complaint to the Information Officer:
Contact Number:
Email Address:

Where we are unable to resolve your complaint, to your satisfaction you have the right to complaint to the Information Regulator.

The Information Regulator: Ms Mmamoroke Mphelo

Physical Address: SALU Building, 316 Thabo Sehume Street, Pretoria

Email: inforreg@justice.gov.za

Website: http://www.justice.gov.za/inforeg/index.html

A. Particulars of Complainant
Name & Surname:
Identity Number:
Postal Address:
Contact Number:
Email Address:
B. Details of Complaint
C. Desired Outcomes
D. Signature Page
Updated by Robert de Jager on 13 JUL 2021
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