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User Name
Password
Confirm Password

Employer Info

Organization Name
Organization Phone
Employer Name
Responsible Person Position
Responsible Person Phone

Complainer Info

Name
Nationality
ID Number
ID Image
On Behalf Of

Beneficiary Info

Name
Is The Beneficiary?
Nationality

Communication Info

Email
Mobile
City
Area

Complaint Info

Previous complaint number
Complaint Description

Supporting Documents

Attached Supporting Documents