Feedback Form Step 1 Personal Details Step 2 Feedback Details Step 3 Terms and Submission Before completing the below form please check that we can help you - see making a complaint and/or complaints we cannot investigate. Please read the "ANIC Feedback/ Complaint Terms and Conditions" before you complete the form below to ensure your complaint/ feedback fits the criteria for consideration. Step 1: Personal details I would like to be kept anonymous By ticking this box I acknowledge that I am submitting this form anonymously and that ANIC will not contact me to discuss the information I have provided. The information you provide in this form will enable ANIC to assess the complaint/ feedback you have provided and take steps as considered appropriate by ANIC. ANIC may disclose personal information to a third party if the disclosure is necessary to prevent or lessen a serious and imminent threat to the life, health or safety of you or another person.Please read through our Complaints Handling Policy for more information Email Title MrMissMrsMs Gender MaleFemale First Name(s) Family Name Address Suburb State Postcode Telephone (preferred contact number) enter without spaces Telephone (mobile) enter without spaces Next Step 2: Feedback details Complaint or Feedback ComplaintFeedback Please give the details of your complaint (maximum length 3000 characters) What do you want to happen for your complaint to be resolved? Please note that we expect complainants to provide us with a copy of their evidence in support of their complaint, such as correspondence with a relevant Party about the complaint. Please attach relevant documents below (if attaching more than 3 documents you will need to submit an additional form): Document 1 Document 2 Document 3 NextPrevious Step 3: Terms & Submission Once you submit the form, we will collect the data entered, including the contact details you provide, to answer your enquiry and any follow-up questions. We do not share this information without your permission. We will, therefore, process any data you enter onto the contact form only with your consent. You may revoke your consent at any time. We will retain the data you provide on the form until you request its deletion, revoke your consent for its storage.