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LASRERA COMPLAINT FORM

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SECTION 1: Personal Details Of Complainant


Please fill all required fields
First Name is required
Last Name is required
Phone number is required
Email is required
Complaint category is required
Street Number is required
Street Name is required
Bus stop / Landmark is required
LGA is required

SECTION 2: Estate Agent Details


Please fill all required fields
First Name is required
Last Name is required
Phone number is required
Street Number is required
Street Name is required
Bus stop / Landmark is required
LGA is required

SECTION 3: Person With Whom You Have Been Dealing


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First Name is required
Last Name is required
Phone number is required
Street Number is required
Street Name is required
Bus stop / Landmark is required
LGA is required

SECTION 4: Complaint


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500 words exceeded!

SECTION 5: Supporting Documents


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Description is required

Upload multiple files with the file dialog or by dragging and dropping files onto the dashed region

SECTION 6:Declarations


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ANONYMOUS REPORT


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Category needed
Subject is required
Maximum of 3,500 characters

Additional Report Information