Phoenix-India

Grievance Registration Form

CITIZEN CORNER

Grievance Pertains to

Shareholder

General

Select Type*

Folio Number *

Name *

Complainant Category *

Male

Female

Others(If an organisation)

Do You want to have a
Password for this Grievance?

Yes

Password*

Address 1*

Address 2

City/Town*

Pincode*

Country *

Phone No.

(ISD Code+STD Code-without '0' prefix+Tel.No) eg : 911100000000

Mobile No.*

(ISD Code & Mobile Number)eg : 919999999999

Email Id.

Please enter Grievance Description upto 4000 characters *

Have you earlier lodged the grievance to
the above organisation on the same subject?

Yes

*Please type the characters appearing in the image below:

I hereby state that the facts mentioned above are true to the best of my knowledge and belief.

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