NAMFISA Complaints Online Form
Please note that before you lodge a complaint with NAMFISA, you should first have consulted the Service Provider.
Particulars of whom the complaint is laid against:
Company name:
Name of Entity :
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Postal Address:
Address line 1:
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Address line 2:
Address line 3:
Town/City:
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If "Other" please specify:
Other
Country:
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Contact person:
Tel:
Fax:
Email Address:
Details of complainant:
Surname:
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Full Names:
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Namibian ID Number/Passport Number:
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Postal Address:
Address line 1:
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Address line 2:
Address line 3:
Town/City:
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If "Other" please specify:
Other
Country:
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Gender:
Male
Female
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Occupation:
Call Centre Agent
Domestic Worker
Hairdresser
Pensioner
Chiropractor
Dentist
Dietitian or Nutritionist
Optometrist
Pharmacist
Physician
Physician Assistant
Podiatrist
Registered Nurse
Therapist
Veterinarian
Health Technologist or Technician
Other Healthcare Practitioners and Technical Occupation
Nursing, Psychiatric, or Home Health Aide
Occupational and Physical Therapist Assistant or Aide
Other Healthcare Support Occupation
Chief Executive
General and Operations Manager
Advertising, Marketing, Promotions, Public Relations, and Sales Manager
Operations Specialties Manager (e.g., IT or HR Manager)
Construction Manager
Engineering Manager
Accountant, Auditor
Business Operations or Financial Specialist
Business Owner
Other Business, Executive, Management, Financial Occupation
Architect, Surveyor, or Cartographer
Engineer
Other Architecture and Engineering Occupation
Postsecondary Teacher (e.g., College Professor)
Primary, Secondary, or Special Education School Teacher
Other Teacher or Instructor
Other Education, Training, and Library Occupation
Arts, Design, Entertainment, Sports, and Media Occupations
Computer Specialist, Mathematical Science
Counselor, Social Worker, or Other Community and Social Service Specialist
Lawyer, Judge
Life Scientist (e.g., Animal, Food, Soil, or Biological Scientist, Zoologist)
Physical Scientist (e.g., Astronomer, Physicist, Chemist, Hydrologist)
Religious Worker (e.g., Clergy, Director of Religious Activities or Education)
Social Scientist and Related Worker
Other Professional Occupation
Supervisor of Administrative Support Workers
Financial Clerk
Secretary or Administrative Assistant
Material Recording, Scheduling, and Dispatching Worker
Other Office and Administrative Support Occupation
Chef or Head Cook
Cook or Food Preparation Worker
Food and Beverage Serving Worker (e.g., Bartender, Waiter, Waitress)
Building and Grounds Cleaning and Maintenance
Personal Care and Service (e.g., Hairdresser, Flight Attendant, Concierge)
Sales Supervisor, Retail Sales
Retail Sales Worker
Insurance Sales Agent
Sales Representative
Real Estate Sales Agent
Other Services Occupation
Construction and Extraction (e.g., Construction Laborer, Electrician)
Farming, Fishing, and Forestry
Installation, Maintenance, and Repair
Production Occupations
Other Agriculture, Maintenance, Repair, and Skilled Crafts Occupation
Aircraft Pilot or Flight Engineer
Motor Vehicle Operator (e.g., Ambulance, Bus, Taxi, or Truck Driver)
Other Transportation Occupation
Military Personnel
Police Officer
Correctional Officer
Fire Fighting
Homemaker
Other Occupation
Don't Know
Not Applicable
Financial Planner
Legal Practitioner
Unemployed
Retail Merchandiser
General Worker
Artisan Foreman
Civil Servant
Ranger
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Work Physical Address:
Address line 1:
Address line 2:
Address line 3:
Town/City:
If "Other" please specify:
Other
Country:
Contact Numbers:
Mobile Number:
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Work Number:
Home Number:
Email Address :
Contact Number of next of kin :
Please insert your personal details should you make this complaint on behalf of someone else.
Are you complaining on behalf of someone else ? :
(If yes, then please provide proof of authorisation below)
If yes, please attach proof at attachments:
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Surname:
*
Full Names:
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Postal Address:
Address line 1:
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Address line 2:
Address line 3:
Town/City:
*
If "Other" please specify:
Other
Country:
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Contact Numbers:
Cell:
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Work:
Home:
Email Address (if any):
Industry
What is the complaint about:
Complaint Typology:
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If Other (Please specify):
Policy Number (If Applicable):
Please set out, circumstances of complaint. Please describe as clearly as possible the complete background of the complaint and attach evidence where applicable.
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Action taken by complainant to resolve the issue.
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Indicate what are your expectations from NAMFISA:
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Where did you here about NAMFISA:
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Radio :
Newspaper:
Television :
Friend/Family :
Other (specify) :
Attachments
Please attach the following documents to support your complaint
If reporting on someone's behalf, please attach proof: (Compulsory):
Please Attach proof of any communication with the entity: (Compulsory)
Certified Copy of Identity Document (Compulsory):
Copy of Contract (If any):
Cancellation Letter (If any):
Copy of Bank Statement (If any):
Policy Document (If any):
Benefit Statement (If complaint is against a Pension Fund):
Repudiation Letter (If any):
Correspondences (If any):
Other:
Should the upload fail, kindly fax documents to the following number
061-2905161
or email to
complaintsdept@namfisa.com.na
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Please check that you have completed the following:
Filled out all sections of the form
Attached any relevant documents
Signed and dated the form
Declaration
I declare to the best of my knowledge and belief that the information and/or documents that I provide are true and correct;
I understand that NAMFISA may disclose the information in this complaint to the Member and, if required, to any regulatory authority;
I/we understand that these authorizations remain in force until the matter which is the subject of the authorization is resolved or until I/we otherwise withdraw the authority;
I/we understand that once a complaint is made and not withstanding that the complainant withdraws complaint, NAMFISA may act on its own accord in assembling evidence and may continue to investigate a complaint if there is sufficient evidence available, without the complaint’s participation.
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