PECR (EC Directive) Regulations 2003 Complaint Form (marketing purposes)v1.xlsx

Complaint Form (Marketing Messages)
Privacy and Electronic Communications (EC Directive) Regulations 2003
You should only use this form to report complaints about marketing messages sent in possible breach of the Privacy and Electronic Communications (EC Directive) Regulations 2003. Do not fill in this form until you have read the 'Privacy and Electronic Regulations- when and how to complain'booklet. If you need help to fill in this form, please contact the ICO Helpline on 0303 123 1113
1.Your Details:       Previous Contact with the ICO
    (Please provide any reference number already given to you)
First Name: I Do not have a reference number.
Other Names: This is the first time I have contacted you.  
Last Name: Have you given permission to anyone else to speak to us about your complaint?
  Do you have a relationship with the sender ?
Post Code:    
Daytime Telephone: (if 'Yes' briefly describe nature of relationship)
2. Person Authorised to Speak to ICO (if applicable)    
    3. Who was the marketing message form? (This will usually be an organisation)
First Name:
Other Names: Name:
Last Name: Address:
Post Code:   Telephone:
Telephone Email:
Fax: Website:
  Have you ever given the organisation permission to contact you in this way?
3.Subscriber Details:        
Are you the subscriber (account holder) for this number or email address?
If 'Yes' have you now asked them to stop?
  How was the message made or sent?
If 'No', who is? (Please specify)
Please give the number or email address on which the marketing communication was received.
Is the number registered with the Telephone Preference Service (TPS)?
(Fax Complaints Only)Is the number registered with the Fax Preference Service (FPS)?
Was the message diverted to you from another number or email?
Date Message Sent    
  Time Message Sent    
Has the receipt of these messages had any practical impact on you? (eg: prevented prevented urgent messages being received, incurred costs etc?)( If 'Yes' please send details.)
In the case of fax and email complaints, ICO will not be able to investigate unless you provide them with copies of the marketing communication you received.  
In all cases, please send copies of any correspondence between you and the organisation or individual concerned in which you registered your objection to receiving such messages or otherwise tried to solve the problem.  
Send only documents that are directly relevant to your complaint. If you send too many irrelevant documents, the ICO may send them back and ask you to return only the relevant ones. In the unlikely event that you need to send a large amount of documents, please clearly mark the relevant parts. If you do not the ICO may return them and ask you to do this. You should also send copies of relevant correspondence between you and any other organisation (for example an industry regulator or ombudsman) trying to solve the problem.  
Important information about your supporting documents
Any paper documents will be scanned and held by the ICO as electronic records. In most cases, the ICO will destroy documents you send after six months. You should only send copies of documents and make sure you keep the originals in case they are needed for later verification. You will need to make it clear each time you send something to the ICO if you would like it to be returned to you. Please list the supporting documents you sent. Do not just write 'see attached' If you cannot provide the ICO with copies and you would like the ICO to return your documents, please tick here.  
I confirm that: I understand that during any necessary investigations, you may need to disclose the details I have provided to the subject of my complaint to allow them to investigate. I have clearly indicated any information which I do not want to pass on. To the best of my knowledge I have given you accurate information relating to this complaint. I understand your policy is to destroy documents relating to complaints after six months. I have clearly indicated those documents that you should not destroy and should return to me. I have listed all the documents I am sending with this form. I have read 'The Privacy and Electronic Communications Regulations-When and how to complain' leaflet and understand that you have no powers to punish an organisation for any likely breach of the regulations and that you cannot award compensation. Please check this box to confirm.  
Are you the person named in section 1 of this form? Please Select: If 'No', please make sure your details are provided in section 2 of this form and check this box to confirm you have permission of the complainant to act on their behalf.  
Sending your complaint to the ICO by email: If you have copies of the supporting documents you need to send, please attach them to the same email as your complaint form, and send to:
By Post: If you only have paper copies of some of the supporting documents you need to send, please print this form and post it along with all your supporting documents to: Customer Service team, The Information Commissioner's Office, Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF. will not be held liable for the accuracy of any such information input or submitted by the end user, and provides this online form for general use. does not collect any information herein entered.(C) 2011

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