Complaint Form in relation to Services provided by

Complaint Form
in relation to banking services
Please complete this form if you wish to make a complaint with the Hong Kong Monetary Authority (HKMA)
against a licensed bank, restricted licence bank or deposit-taking company (collectively referred to as banks).
Before you make a complaint, please read the frequently asked questions on the webpage “Complaints about
Banks” of the HKMA’s website (www.hkma.gov.hk) which explain the HKMA’s role and procedures in handling
complaints.
1.
Who is making the complaint?
Name / Company name
(Mr / Mrs / Ms*)
Identity document no. (first 4 digits)
(HKID / Passport / Travel document*)
Company’s authorised representative (if applicable)
(Mr / Mrs / Ms*)
Correspondence address
Telephone no.
*delete where appropriate.
2.
Who are you complaining about?
Name of the bank
Name of the staff
3.
Email
Branch / Department
Job title
(If you have a business card of the staff, please attach a copy of it to this form.)
What is your complaint about?
Please describe precisely in point form all the matters you are not satisfied with:
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Please describe the incident(s) giving rise to your complaint, preferably in chronological order.
It will help us handle your complaint if you can provide us with relevant information such as the date, time, place,
identity of the parties involved and a copy of the relevant documents.
(If you need more space, please continue on a separate piece of paper and attach it to this form.)
04.2015
Please provide details of the account or transaction involved in your complaint:
Account no.
Name of account holder
Account type
(e.g. Current / Savings / Time deposit / Loan / Securities / Credit card, etc.)
Product name
Transaction date (dd / mm / yyyy)
Disputed amount (Transaction amount / Loss / Interest / Fee*)
(If your complaint involves multiple accounts/transactions, please list them on a separate piece of paper and attach it to this form.)
*delete where appropriate.
4.
Have you lodged a complaint with the bank?
No
5.
Yes
Bank’s complaint reference no. (if yes)
(If the bank has handled your complaint and replied to you in writing, please attach a
copy of it to this form.)
Consent to disclose your information and personal data
I would like the HKMA to consider and handle my complaint.
•
•
•
•
I understand and agree that all information and personal data supplied by me will be used for purposes
related to the handling and/or investigation of my complaint and the discharge of the HKMA’s
statutory functions;
I understand and agree that the HKMA may disclose or transfer the information and personal data
supplied by me to third parties (1) for purposes related to the handling and/or investigation of my
complaint, including the bank and/or its staff who are the subject of the complaint and other relevant
regulators, authorities and law enforcement agencies; and (2) where permitted or required by law;
I understand that should I wish to request access to or correction of my personal data held by the
HKMA, I may do so in writing to the Personal Data Privacy Officer of the HKMA at the address
shown below. The HKMA may charge a reasonable fee for complying with a data access request; and
I understand that I am not obliged to supply the HKMA with information and personal data and agree
to do so on a voluntary basis. If the information or personal data provided by me are not accurate or
complete, the processing of my complaint may be affected.
If you wish to appoint a representative, please complete the following:
I authorise
(Name),
Identity document no. (first 4 digits)
(HKID / Passport / Travel document*),
Correspondence address / Email
and Telephone no.
to submit information and to enquire about the progress of my complaint.
*delete where appropriate.
Signature
Signature of authorised
representative (if applicable)
Date
(If the complaint is made by a company, the complaint form must be signed by a director or a representative of the company with
authority to sign and to give the consent in part 5 on behalf of the company and stamped with the company chop.)
Please submit this completed form and supporting
papers in person to the drop box at the concierge desk
located in the HKMA lobby or by post:
By Fax: 2509 3990
By Email: [email protected]
For enquiries, please call: 2878 1378
04.2015
Complaint Processing Centre
Hong Kong Monetary Authority
55th Floor, Two International Finance Centre
8 Finance Street, Central, Hong Kong