Grievance Lodgement Form Complainant Name *Email Address *Phone *Vehicle Number *Date of Complaint *DaySelect day12345678910111213141516171819202122232425262728293031MonthSelect month123456789101112YearSelect Year21242123212221212120211921182117211621152114211321122111211021092108210721062105210421032102210121002099209820972096209520942093209220912090208920882087208620852084208320822081208020792078207720762075207420732072207120702069206820672066206520642063206220612060205920582057205620552054205320522051205020492048204720462045204420432042204120402039203820372036203520342033203220312030202920282027202620252024202320222021202020192018201720162015Type of complaint drop-downSelectType 1Type 2Type 3Type of complaint *Responsible MDA *Description of complaint *Unauthorized Payment/Other in kind request *Amount LostNGNName of responsible party *Attach any supporting documents hereChoose FileNo file chosenDelete uploaded fileSubmit!
