Government of India
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Grievance Registration Form

(Entries prefixed with * must be filled)
*Grievance Pertains to
*Select Ministry/Department
* Grievance Pertains To
*Name
Complainant Category
Do You want to have a
Password for this Grievance?
*Address
 
 
Pincode
Country
State
Phone No.
(ISD Code+STD Code-without '0' prefix+Tel.No) eg : 911123367688
Mobile No.
(ISD Code & Mobile Number)eg : 919999999999
Email Id.
*Please enter Grievance Description upto 4000 characters
*Have you earlier lodged the grievance to
the above organisation on the same subject?
Please provide the details of Past Reference(s), with date :-
Reference Number (If any) Date of Reference
1.
2.
3.
4.
5.

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I hereby state that the facts mentioned above are true to the best of my knowledge and belief.
  
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