COMPLAINT FORM
Section: 1 – COMPLAINANT’S DETAILS (Only complete this section if you are
complaining on behalf of another person.)
Name:
Surname:
Identity number:
Relation to the
claimant:
Telephone number:
Alternative number:
Email address:
Postal Address:
Physical Address (if not the same
as postal):
Is this complaint accident related?
YES/NO
Have you lodged your complaint
with other institutions?
YES/NO
If Yes, state where:
Section: 2 – CLAIMANT’S DETAILS (Only complete this section if you are not the
injured.)
Name:
Identity number:
Surname:
Relation to the injured:
Telephone number:
Alternative number:
Email address:
Postal Address:
Physical Address (if not the same
as postal):
Claim
Reference and Branch
(if known):
Section: 3 – INJURED’S/DECEASED’S DETAILS
Surname:
Name:
Identity number:
Relation to the
claimant:
Telephone number:
Alternative number:
Email address:
Postal Address:
Physical Address (if not the same
as postal):
Claim
Reference and Branch
(if known):
Have you lodged your complaint
with other institutions?
YES/NO
If Yes, state
where:
Section: 4 – Please give a detailed description of your complaint
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DATE: --------------------------SIGNATURE: -------------------
Kindly submit completed form, to the RAF, by email (complaints@raf.co.za) or by fax (0878098860)
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