Linguistic Human Rights Violation Complaints Form

    Your Details






    Details of the Person in the event the complaint is lodged on behalf of that person/organisation





    State Your Complaint

    The complaint is against (Name, Surname if its natural person & Name if its Organ of the State , Juristic person or any Organization contact details) . If you don’t know the names, please tell us anything you know about them

    In Your Own Words, Tell Us Exactly What Happened. Include All The Information You Think Is Important

    (Please be free to attach as annexure if your information regarding the circumstances of your cannot be fully completed in this section)

    Have you reported this case to anyone else?

    YesNo

    If so, who?
    (For example, - Police, Lawyers, Public Protector, Human Rights Commission, Commission on Gender Equality, Land Claims, South African Heritage Resources Agency, Provincial Heritage Resources

    Consent: Can we use your name in news reports or letters we write for you?

    Once you have filled in this form, please post, fax, email or whatsApp it to any of the PanSALB Offices throughout the country. Please note the contact details attached hereto Annexure A