Financial Ombudsman Service Professional Representatives

This form is to be used by professional representatives only. Please use this form to tell us about your customer's complaint – so we can help resolve it. As you have agreed to make this complaint on someone else's behalf, you will need to upload a signed declaration form for each complainant.

Details of the person bringing the complaint (your customer)

Title

First name

Surname

Date of birth

Address line 1

Address line 2

Town

County

Country

Postcode

Phone number 1

Phone number 2

Email

Are there multiple complainants, for example a joint policy/account holder?

Please provide signature for all complainants on the declaration form

Title

First name

Surname

Date of birth

Address line 1

Address line 2

Town

County

Country

Postcode

Phone number 1

Phone number 2

Email

Is the complaint being brought on behalf of a business, charity or trust?

Its full official name

What is the status of the business, charity or trust?

If the business, charity or trust is an organisation, name all the directors/partners/trustees of this organisation

Name any staff members who have been authorised to represent the organisation (and provide their contact details)

If complaining on behalf of a business

If a partnership, the number of partners

Number of employees

Its annual turnover, annual income or net asset value (at the time the first complaint was made, in pounds)

Its balance sheet (at the time the first complaint was made, in pounds)

Is this business linked to or partnered with another business?

If yes, list the businesses linked to or partnered

If complaining on behalf of a charity or trust

Its annual income (at the time the first complaint was made, in pounds) – if complaining on behalf of a charity

Its net assets (at the time the first complaint was made, in pounds) – if complaining on behalf of a trust

The business being complained about

Their name

Their address

You will usually find this on communication from the business, such as letters or emails. Please type it here exactly as it shows on their communications

What's happened so far?

When did the advice, claim, service or transaction being complained about take place?

Has a complaint already been made to the business?

We can only look into complaints where a final response letter has been received from the business being complained about. Or where the business hasn't responded within our stated time limits. We will not accept any complaints from professional representatives which do not meet this criteria.

If yes, when did you complain to the business?

Has the business being complained about sent its final written answer? (please remember to attach this at the end of this form if 'yes')

If yes, when was the final written answer received?

If it has been longer than six months since a final response was received from the business, you are likely out of time to refer the complaint to our service, unless this was as a result of exceptional circumstances. See our time limits page for more information.

Has there been any court action related to the complaint (or is any planned)?

The Complaint

Tell us about the product or service being complained about

Which type of insurance

In the words of the complainant, what is the complaint about?

Please complete the additional questions relating to irresponsible or unaffordable lending and upload with your support files for this complaint.

Please complete the additional questions relating to disputed transactions and upload with your support files for this complaint.

Please provide a complaint or other reference number for this product or service?

Tell us about the complaint – what happened?

0/50000

How has the complainant been affected – financially or otherwise?

Why do you disagree with how the business has handled the complaint so far, and what do you feel needs to be done to put things right?

Upload your support files

You will need to upload a signed declaration form covering every complainant on this complaint. We will not be able to accept a complaint without this. Here is a link to our declaration form.

Signed complainant declaration
A copy of the key facts document (sometimes called a key features document). This shows us the type of pension the complainant has
Final Response Letter from the business, or evidence of an email or letter to show a complaint has been made to the business more than 8 weeks ago
Policy documents (if applicable)
Finance agreement (if applicable)
Grant of Probate (if the complainant has passed away)
Power of Attorney (if applicable)
Any other documented evidence the complainant can provide which you feel is relevant to the case

Signed complainant declaration
A copy of the policy schedule. This shows who is covered by the insurance and the kind of cover the complainant has have
Final Response Letter from the business, or evidence of an email or letter to show a complaint has been made to the business more than 8 weeks ago
Policy documents (if applicable)
Finance agreement (if applicable)
Grant of Probate (if the complainant has passed away)
Power of Attorney (if applicable)
Any other documented evidence the complainant can provide which you feel is relevant to the case

Signed complainant declaration
A copy of the credit or finance agreement
Bank Statement – which shows evidence of the customers income
Final Response Letter from the business, or evidence of an email or letter to show a complaint has been made to the business more than 8 weeks ago
Policy documents (if applicable)
Finance agreement (if applicable)
Grant of Probate (if the complainant has passed away)
Power of Attorney (if applicable)
Any other documented evidence the complainant can provide which you feel is relevant to the case

Signed complainant declaration
A copy of the complainant’s mortgage offer(s) if applicable to the complaint
Final Response Letter from the business, or evidence of an email or letter to show a complaint has been made to the business more than 8 weeks ago
Policy documents (if applicable)
Finance agreement (if applicable)
Grant of Probate (if the complainant has passed away)
Power of Attorney (if applicable)
Any other documented evidence the complainant can provide which you feel is relevant to the case

Signed complainant declaration
Any screenshots of the transaction or payment being complained about
If the business hasn't responded to the complaint in the time allowed, please upload a recent letter or bank statement which shows who the account holders are
Final Response Letter from the business, or evidence of an email or letter to show a complaint has been made to the business more than 15 days ago
Policy documents (if applicable)
Finance agreement (if applicable)
Grant of Probate (if the complainant has passed away)
Power of Attorney (if applicable)
Any other documented evidence the complainant can provide which you feel is relevant to the case

Signed complainant declaration
A copy of the complainant’s investment certificate if applicable to the complaint
Final Response Letter from the business, or evidence of an email or letter to show a complaint has been made to the business more than 8 weeks ago
Policy documents (if applicable)
Finance agreement (if applicable)
Grant of Probate (if the complainant has passed away)
Power of Attorney (if applicable)
Any other documented evidence the complainant can provide which you feel is relevant to the case

Signed complainant declaration
Final Response Letter from the business, or evidence of an email or letter to show a complaint has been made to the business more than 8 weeks ago
Policy documents (if applicable)
Finance agreement (if applicable)
Grant of Probate (if the complainant has passed away)
Power of Attorney (if applicable)
Any other documented evidence the complainant can provide which you feel is relevant to the case

Signed complainant declaration
A copy of the credit or loan agreement
Final Response Letter from the business, or evidence of an email or letter to show a complaint has been made to the business more than 8 weeks ago
Policy documents (if applicable)
Finance agreement (if applicable)
Grant of Probate (if the complainant has passed away)
Power of Attorney (if applicable)
Any other documented evidence the complainant can provide which you feel is relevant to the case

Signed complainant declaration
A copy of the credit or loan agreement
Final Response Letter from the business, or evidence of an email or letter to show a complaint has been made to the business more than 8 weeks ago
Policy documents (if applicable)
Finance agreement (if applicable)
Grant of Probate (if the complainant has passed away)
Power of Attorney (if applicable)
Any other documented evidence the complainant can provide which you feel is relevant to the case

Signed complainant declaration
If the business hasn't responded to the complaint in the time allowed, a recent letter or bank statement which shows who the account holders are
Final Response Letter from the business, or evidence of an email or letter to show a complaint has been made to the business more than 8 weeks ago
Policy documents (if applicable)
Finance agreement (if applicable)
Grant of Probate (if the complainant has passed away)
Power of Attorney (if applicable)
Any other documented evidence the complainant can provide which you feel is relevant to the case

Signed complainant declaration
Final Response Letter from the business, or evidence of an email or letter to show a complaint has been made to the business more than 8 weeks ago
Policy documents (if applicable)
Finance agreement (if applicable)
Grant of Probate (if the complainant has passed away)
Power of Attorney (if applicable)
Any other documented evidence the complainant can provide which you feel is relevant to the case Any other documented evidence you can provide which you feel is relevant to your case

I confirm that I have uploaded a signed declaration form.

Drop files here
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