COMPLAINT FORM

FORM 5
[Regulation 10]

NOTE:

1. This form is designed to assist the Requester or Third Party (hereinafter referred to as “the Complainant”) in
   requesting a review of a Public or Private Body’s response or non-response to a request for access to records
   under the Promotion of Access to Information Act, 2000 (Act No. 2 of 2000) (“PAIA”). Please fill out this form
   and send it to the following email address: PAIAComplaints@infoRegulator.org.za or complete online
   complaint form available at https://www.justice.gov.za/inforeg/.
2.  PAIA gives a member of the public a right to file a complaint with the Information Regulator about any of the
   nature of complaints detailed in part F of this complaint form.
3. It is the policy of the Information Regulator to defer investigating or to reject a complaint if the Complainant has
   not first given the public or private body (herein after referred to as “the Body”) an opportunity to respond to and
   attempt to resolve the issue. To help the Body address your concerns prior to approaching the Information
   Regulator, you are required to complete the prescribed PAIA Form 2 and submit it to the Body.
4. A copy of this Form will be provided to the Body that is the subject of your complaint. The information you
   provide on this form, attached to this form or that you supply later, will only be used to attempt to resolve your
   dispute, unless otherwise stated herein.
5. The Information Regulator will only accept your complaint once you confirm having complied with the
   prerequisites below.
6. Please attach copies of the following documents, if you have them:
   a. Copy of the form to the Body requesting access to records;
   b. The Body’s response to your complaint or access request;
   c. Any other correspondence between you and the Body regarding your request;
   d. Copy of the appeal form, if your compliant relate to a public body;
   e. The Body’s response to your appeal;
   f. Any other correspondence between you and the Body regarding your appeal;
   g. Documentation authorizing you to act on behalf of another person (if applicable);
   h. Court Order or Court documents relevant to your complaint, if any.
7. If the space provided for in this Form is inadequate, submit information as an Annexure to this Form and sign
   each page.

[contact-form-7 id=”10241″ title=”PAIA Form 5″]