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Sex MaleFemale
Date of Birth
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Subject of Complaint (Please select the subject of any claim related to your claim) AbuseDelay in operationInterest calculationMistakes of Relationship OfficersAccounting errorsCheatingQuality of creditLoan collectionService and productsOther
Type of Service General LoanStaff LoanE9 LoanCE LoanOther
Complaint through VerbalPhoneTicket / ApplicationDirect messageEmailOther
Reason for filling a complaint (description of the case)
Notes on privacy and recognition By signing this claim form, I acknowledge and allow to use this form in resolving complaints as well as reporting and/ or disclosing information to the National Bank of Cambodia and other relevant authorities. I certify that the information provided above is true and correct. To testify, I would like to give a thumbs up/ signature to confirm