Name of Channel *

Programme Title / Broadcast Item *

Category of Complaint * - Select - Content Related Complaints Quiz shows Films News Related Ads related Teleshopping related complaint

Surname *

First Name *

Gender * - Select - Male Female

Mobile No. & Landline No

E-mail Id *

Fax Number

All complaints decided by the Council may be made publicly available including the name of the complainant. However, in the event of complainant has valid concerns relating to privacy issues in making a complaint, the Council may in its absolute discretion consider requests from the complainant for anonymity/ confidentiality.