Data Privacy Complaint - The Jamaica National Group

Complainant Details

Name

First

Last

Telephone

Home

Mobile

Email

If you are complaining on behalf of someone else, please include that person’s name and your relationship to him/her.

NOTE: Please submit proof of authorization with this form (e.g. Power of Attorney)

Jamaica National Member Company Information

Company

Location

Products

Details of the Complaint

Please indicate how you believe your privacy has been breached.

Tell us what happened

(Please provide sufficient details to enable the Company to appropriately investigate your complaint e.g. what happened, when and where it happened, who was involved, how you believe your personal data has been mishandled)

Please identify any third party (other than a JN member company) involved in the incident giving rise to the complaint.

Note: It may be necessary for the Company to contact any third parties named in the complaint which may necessitate disclosing your identity and the nature of your complaint. If you advise the Company that you do not wish for it to do so, that may mean that the Company cannot properly investigate and resolve your privacy complaint.

Do you consent to the Company contacting the third party named above?

Accept

I do not accept

How would you like the issue to be resolved?

Please attached a copy of your Photo ID along with any documents you consider may assist the Company’s investigation of your privacy complaint.

ID Upload

Maximum file size: 1MB

Document upload

Maximum file size: 1MB

Accept*

The information shared in this form will be used to achieve speedy resolution of your complaint and will be processed in accordance with the JN Group Privacy Notice.

Complainant’s Signature:

Date

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Jamaica National Member Company Information

Details of the Complaint

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