Complaint form

PERSONAL DETAILS OF THE COMPLAINANT
(Please write in BLOCK LETTERS).

SURNAME : .................................................................................................................................................................
NAME : ......................................................................................................................................................................
FATHER�S / HUSBAND�S NAME :.................................................................................................................................
ADDRESS : STREET : ........................................ NUMBER.: ............ CITY : .......................... POSTAL CODE. : ............
PHONE NUMBER(S) : .................................................. F�� : ................................... E-MAIL : .................................

PERSONAL DETAILS OF THE AUTHORIZED REPRESENTATIVE
(Please write in BLOCK LETTERS).

SURNAME : ...............................................................................................................................................................
NAME : .......................................................................................................................................................................
FATHER�S / HUSBAND�S NAME : .................................................................................................................................
ADDRESS : (Please complete this area only if you are authorized to receive correspondence from
the Banking Ombudsman concerning the complaint at your address).
STREET :............................................... NUMBER :.................... CITY : .............................. POSTAL CODE :.....................
PHONE NUMBER(S) : ............................................. F�� : ....................................... E-MAIL : ........................................

THE BANK YOUR COMPLAINT CONCERNS (Bank, Branch):
....................................................................................................................................................................................
HAVE YOU ALREADY SPOKEN TO THE BRANCH DIRECTOR? (Please check the appropriate box): YES   [ ]        NO [ ]
HAVE YOU ALREADY APPLIED TO THE BANK�S CUSTOMER SERVICE DEPARTMENT? (Please check the appropriate box): YES   [ ]        NO [ ]              IF YES, WHEN    ............../............../................
HAVE YOU RECEIVED AN ANSWER FROM THE BANK�S CUSTOMER SERVICE DEPARTMENT? (Please check the appropriate box): YES   [ ]        NO [ ]             IF YES, WHEN?:     ............../............../................
HOW DID YOU LEARN ABOUT THE BANKING OMBUDSMAN? (Please check the appropriate box): FROM THE BANK [ ] FROM ANOTHER SOURCE [ ] (Please state which source) ��...

Please give a brief summary of your complaint or, if you have already done so in a letter to the Banking Ombudsman, please add any new information (please read carefully paragraphs 3 and 4 of the instructions on the other side of this Form).

Please list below any documents you consider relevant to your complaint, and attach them (original or certified copy) to this Form.

1. ....................................................................................................................................
2. ....................................................................................................................................
3. ....................................................................................................................................
4. .....................................................................................................................................
5. .....................................................................................................................................
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SOLEMN DECLARATION

I submit for examination by the Banking Ombudsman the complaint described above (or described in a letter already sent to him/her) and agree to him/her dealing with it in accordance with the terms described in the Brochure of the Banking Ombudsman which I have taken cognizance of.

I hereby declare that all the information above is accurate.

I solemnly declare that the complaint I hereby submit to the Banking Ombudsman is not the subject of any proceedings before any Court of Law or Arbitration.

I authorize the bank to disclose to the Banking Ombudsman any information or documents which he/she may request in order to examine my case, with the exception of information which is covered by banking confidentiality.

I understand that the submission of my complaint to the Banking Ombudsman does not suspend any legal deadlines regarding my taking the case to Court or Arbitration (e.g. taking legal action against the bank through the Courts).

PLACE : ............................... DATE : ........../.........../............

FULL NAME(S)	SIGNATURE(S)
..............................................................................	..............................................
..............................................................................	..............................................
..............................................................................	..............................................
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(please write in BLOCK LETTERS)

In order to facilitate the Banking Ombudsman�s task, please answer all the questions on this Form.
If you have already contacted us, it will be of assistance if you quote the reference number already assigned to you in our written response.
Please fill out this Form legibly, with blue or black ink and briefly explain in a clear and straightforward way your complaint. It is essential that you mention the circumstances under which your complaint arose (for example *the exact date *whether it occurred for the first time *the types of transaction involved *the number and the type of the account *what was the position of the bank *what department(s) of the bank you applied to, as well as what you expect from your bank and the Banking Ombudsman.
It is not necessary to repeat details already mentioned in your previous correspondence with the Banking Ombudsman.
It is important to know that the banks are prohibited from disclosing information of their customers� accounts. Therefore, in order for the Banking Ombudsman to examine your case, all information which is relevant to your case should be included in this Form.
It is also essential to send the Banking Ombudsman the original or certified copy of any documents relevant to your case along with this Form (e.g. agreement for the opening of an account, correspondence with the bank, copies of statements of your account, etc.). You should keep a copy of the completed Complaint Form and of the attached documents.
If the case concerns a joint account held with another or others in the bank, this should be reported and both (or all) of the account holders need to sign this Form.
If you are authorized to act on behalf of one or more complainants, for certain or all acts related to the examination of the complaint by the Banking Ombudsman (e.g. to sign this Form, to receive all correspondence concerning the case from the Banking Ombudsman, to respond to this correspondence, to accept or reject his/her recommendations etc.), it is essential to attach his/her/their written authorization together with certification of the authenticity of the signature/s from a Public Authority. In such a case, you should explain clearly in this Complaint Form to the Banking Ombudsman that you are making a complaint on behalf of another individual or individuals, as well as the reasons for which the individual(s) concerned is/are not making the complaint himself/herself/themselves. If the recipient of banking services is deceased, you should attach all relevant documents proving your legal interest.
After completing the present Form, fold and mail it, together with any supporting documents relevant to the case (original or certified copy) to the Banking Ombudsman, using the attached reply envelope.

ATTENTION: The submission of your complaint to the Banking Ombudsman does not suspend any legal deadlines regarding taking the case to Court or Arbitration to pursue the settlement of your dispute with the bank.

Copies of the Information Brochure and the Complaint Form to the Banking Ombudsman (also in Greek) are provided free of charge from banks which participate in the scheme (see relevant list at the end of the brochure) from the Office of the Banking Ombudsman [Karagiorgi Servias 12-14, 105 62 Athens, Tel. 010 - 3376700] and on the Internet:www.bank-omb.gr