Lodge a Complaint (Form DPC 1) — Entity Portal

PART A — COMPLAINANT PARTICULARS

Complainant Full Name*

National ID / Passport Number*

Date of Birth*

Gender*

Male

Female

Other

Nationality*

Email Address*

Telephone / Mobile Number*

County of Residence*

Postal Address

Physical Residential Address*

Are you lodging this complaint in person or through an authorized representative?*

In Person (Self)

Through an Authorized Representative / Advocate

Representative Full Name (if applicable)

Relationship / Legal Capacity

Representative Contact Info

PART B — RESPONDENT PARTICULARS

Name of Respondent (Organization / Entity / Individual)*

ODPC Registration No. (if known)

Respondent Official Email*

Respondent Telephone / Mobile*

Respondent Postal Address

Contact Person / DPO (if known)

Respondent Physical Address / Office Location*

PART C — DETAILS OF COMPLAINT & VIOLATION

Primary Nature of Privacy Violation*

If Other, please specify nature of violation

Date of Incident / Occurrence*

Detailed Narrative of Complaint*

PART D — RELIEF SOUGHT & SUPPORTING EVIDENCE

Specific Relief / Remedy Sought from the Data Commissioner*

National ID / Passport Document Copy*

Upload a legible scanned copy of Complainant National ID or Passport (PDF, PNG, JPG).

Letter of Authorization / Power of Attorney

Required if filing through an advocate or representative (PDF).

Supporting Evidential Files

Upload relevant emails, SMS messages, letters, contracts, or screenshots (PDF or ZIP).

PART E — STATUTORY DECLARATION & VERIFICATION

Declaration of Truth*

I solemnly declare and affirm that the statements made in this complaint are true, correct, and complete to the best of my knowledge and belief. I understand that providing false information is an offense under Section 73 of the DPA 2019.

Signatory Full Name (Electronic Signature)*

Date of Declaration*

Complaint Lodging Form (Form DPC 1)

PART A — COMPLAINANT PARTICULARS

PART B — RESPONDENT PARTICULARS

PART C — DETAILS OF COMPLAINT & VIOLATION

PART D — RELIEF SOUGHT & SUPPORTING EVIDENCE

PART E — STATUTORY DECLARATION & VERIFICATION