Create Website Complaint

Name

Mobile Number

Email ID*

Violation Shop/Organization Name

Violation Type*

Other Violation Type

Date of Violation*

Location Type

Other Location

State*

Other State

District*

Other District

Street Name*

City*

Remarks

I would like the complaint to be sent under my name

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Attach Complaint Video (Max - 10 MB)

Attach Complaint Audio (Max - 1 MB)