Complaint Form

Select the type of information that you wish to supply to the Commission (required)

Complaint

Tip

Select the type of complaint (required)

Complaint against a Firm or Individual

Complaint against the Commission

Complainant Information

Title (required)

First Name (required)

Last Name (required)

Address Line 1 (required)

Address Line 2

Town / City (required)

Zip code

Country (required)

Telephone (Home) (required)

Telephone (Mobile)

Email address (required)

Personal Information

Title

First Name

Last Name

Address Line 1

Address Line 2

Town / City

Zip code

Country

Telephone (Home)

Telephone (Mobile)

Email address

Complaint against a Firm or Individual

Name of Firm OR Name of Individual (required)

If name of form or individual is not listed above please select 'Other'.

Other (required)

Type of Complaint (required)

Please provide a comprehensive detail of your complaint in chronological order inclusive of names of persons, place of meeting, date(s) of meeting, documentations provided etc. Please be as detailed as possible (required)

Are you submitting on behalf of someone else? (required)

Yes

Your Personal Information

Name (required)

Address (required)

Telephone Number (required)

Mobile Number (required)

Email address (required)

Complaint Type (required)

Timeliness

Responsiveness

Work Attitude

Professional Knowledge

Display of Notice/Circular

Other

Date Incident occurred (required)

Officer or Department involved: (required)

Mode of Contact (required)

Please specify mode of contact (required)

Please provide a comprehensive detail of your tip in chronological order inclusive of names of persons, place of meeting, date(s) of meeting, documentations provided etc. Please be as detailed as possible (required)

Attachments

Please attach any documentation you may have. Maximum size 10MB (Allowed formats JPG, PDF)

I hereby certify that the statement and information contained in this form and any attachment hereto are true and correct to the best of my knowledge and belief and submitted in compliance with the Order of the Commission date September 1, 2016. I understand that any misrepresentation, falsification or material omission of information on this application may result in a breach of the Securities Act, 2012

Yes, I hereby certify (required)

Date (required)

Name of Submitting Party. Print in block letters. (required)

Important notes:
1. If the Commission considers that your matter falls within the jurisdiction of another government organization, regulator or agency, in the Republic of Trinidad & Tobago or elsewhere, we may send your information to that other government organization, regulator or agency.
2. If you are concerned about transmitting confidential or sensitive information to the Commission over the internet, please print and mail this form to us.
3. The information you have provided will be treated in confidence and will not be disclosed except as required by law or as may be necessary to investigate your complaint.

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Select the type of information that you wish to supply to the Commission (required)

Complaint

Tip

Select the type of complaint (required)

Complaint against a Firm or Individual

Complaint against the Commission

Complainant Information

Title (required)

First Name (required)

Last Name (required)

Address Line 1 (required)

Address Line 2

Town / City (required)

Zip code

Country (required)

Telephone (Home) (required)

Telephone (Mobile)

Email address (required)

Personal Information

Title

First Name

Last Name

Address Line 1

Address Line 2

Town / City

Zip code

Country

Telephone (Home)

Telephone (Mobile)

Email address

Complaint against a Firm or Individual

Name of Firm OR Name of Individual (required)

If name of form or individual is not listed above please select 'Other'.

Other (required)

Type of Complaint (required)

Are you submitting on behalf of someone else? (required)

Yes

Your Personal Information

Name (required)

Address (required)

Telephone Number (required)

Mobile Number (required)

Email address (required)

Complaint Type (required)

Timeliness

Responsiveness

Work Attitude

Professional Knowledge

Display of Notice/Circular

Other

Date Incident occurred (required)

Officer or Department involved: (required)

Mode of Contact (required)

Please specify mode of contact (required)

Attachments

Please attach any documentation you may have. Maximum size 10MB (Allowed formats JPG, PDF)

Yes, I hereby certify (required)

Date (required)

Name of Submitting Party. Print in block letters. (required)

Type the characters (required)

This field should be left blank

Please wait...

Investor Protection

Complaint Form

TTSEC