Consumer
Dispute
Dispute - Personal Section
All fields marked with (*) are mandatory
Personal Information
Customer Name
*
Gender
*
Select
Female
Male
Transgender
Date of Birth
*
Contact Details
Mobile Number
*
Email ID
*
Identification Details
Identity Proof
*
Select
PAN Card
Passport
Voters ID
Drivers License
Ration Card
Identity Proof No.
*
Service Request
Service Request
Dispute ID
Describe your query
*
Remaining Characters :
UPLOAD DOCUMENT
When uploading documents, please note the following :
Ensure the documents are not password-protected.
Upload latest address proof wherein address and transactions are not older than 3 months from current date.
Upload documents with extension as PNG, JPG, JPEG, PDF etc.
Max. file size is 5MB per upload.
Max. 5 Attachments are permitted at a time.
Enter the characters shown in the image
*
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