something like that

    1. Details of the complainant:

    Address/Registered office:*

    2. Please choose the type of claim:

    3. Please enter your claim in the text box below or upload it as a document. Please upload attachments if necessary.

    Claim and/or its attachements:
    (maximum file size: 8 MB, pdf, jpg and jpeg format allowed):

    Further attachements (maximum file size: 3 MB, pdf, jpg and jpeg format allowed):


    4. Please accept the following declarations:*