Register a Dispute Online

Applicants Details
Fields marked with *are mandatory
Applicants name *
Address line 1
 *
Address line 2
Town/Suburb *
State *
Post code
 *
Tel no. (o/h)
Tel no. (a/h)
 *
Fax no.
Email address
 *
   
Institution Details
Name of Institution
 *
Institution Type *
Membership or account number
Branch
Contact person
 *
Organisation first notified of complaint
 *
 
Dispute Details
Details of your dispute
 

PLEASE NOTE

Your dispute WILL NOT be processed until your supporting documents have been recieved by our office.

If you are lodging the dispute on behalf of a business please contact our office and request that a Small Business Declaration Form be sent to you for completion.

 
Please print a copy of this for your own records prior to submitting this form.

Privacy

The Financial Co-operative Dispute Resolution Scheme. recognises the importance of your privacy and is committed to protecting personal and/or sensitive information about you that it holds.

The Scheme’s Privacy Policy describes how it manages this information and safeguards your privacy.

Copies of the Privacy Policy are available on request from the office at PO Box 372 Clayfield 4011, or from the website at http://www.fcdrs.org.au.By submitting this form you agree that the office of the Ombudsman can disclose to your Credit Union or Building Society any information you provide when you lodge your written dispute.

PO Box 372 Clayfield Queensland 4011
Telephone: 1300 139 220 Facsimile: 1300 139 221
Email: info@fcdrs.org.au