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ComplaintForm

Complaint Form
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The Adjudication Registry can only consider complaints in respect of the functions of an adjudicator, or the Registry, under the Act. If you are dissatisfied about an adjudication decision please seek independent legal advice.

Complainant details

What is the type of the complainant? *
At least one of the phone or mobile numbers is required *

Contact person

Please indicate preferred method of receiving correspondence *

Postal address

Complaint details

List the reasons for the complaint. For each item: 1.Write concise details of your complaint. 2.If you wish to attach further documentation to this complaint form please identify the annexure in the space provided.
Who is the complaint against? *

Complainant's representative

Is there an agent acting on behalf of the Complainant? *

Agent contact details

What is the type of the agent? *
At least one of the phone or mobile numbers is required *

Contact person

Agent postal address

Declaration

PRIVACY NOTICE
The QBCC is collecting the information on this application to form statistical data relevant to the administration of the registry. Collection of this information is authorised by the Building and Construction Industry Payments Act 2004 (The Act). This information can be disclosed by the QBCC as part of the administrate function of the registry or as required by law. The information you provide on this form will be entered into an internal database owned and maintained by the QBCC as required under the Act. In accordance with the Electronic Transactions (Queensland) Act 2001, the registry may provide notices or correspondence to you by electronic communication. By completing this application, your consent to this form of contact is taken to be given. Further details about the QBCC’s Privacy Statement and the collection of personal information may be found on the QBCC’s website.
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