How would you like to be kept informed of the status of your concern:
With Regards to the Incident
Category:
Sub Category:
Village:
Ward:
Street No/Stand No/House No:
Suburb:
City/Town:
District:
Municipality:
Department Type:
Department:
Specify Other Department:
Name of Councillor or Tribal Chief:
Landmarks:
Kindly provide a description of any identifiable landmarks in the area such as cell phones towers, shopping centres, details of schools or any other well-known buildings or structures. This will assist officials to locate the exact area where the incident is taking place.
Incident Details
Please provide a detailed description of the concern with specific reference to the following:
What type of service is involved?
Provide a detailed description of the problem or concern with specific reference to dates, people involved as well as what transpired. Tell us what the problem entails and provide as much information as possible.
Provide the correct physical address. Provide the exact physical address where the irregularities are taking place. Please provide the stand or street number, name of the street, name of the village/suburb as well as the name of the city or town. This information is vital in order to establish the exact location of the concern.
Kindly provide the municipal account number if applicable.
When did the non-delivery of service start?
How did you become aware of the issue?
Department Responsible
Provide the details of the department/body/organisation responsible for this service.
What is the physical address for this department?
Was this incident previously reported to any authority/department? Yes No
If yes, provide the names and designations of officials as well as the physical address of the department and contact details available.
Provide the reference number for this previous report submitted.
When was the issue reported?
Who investigated the concern/complaint?
What actions were taken?
Provide the details of the tribal chief/councillor in your area.
Is the tribal chief/councillor aware of this? Yes No
Evidence / Supportive Documentation
Do you have any supportive documentation? (written complaints submitted/ newspaper articles/statements/emails/faxes) Yes No
Can you send this to us? Yes No
You may forward evidence via free fax: 0800 867 45;
Email: talk2me@premier.limpopo.gov.za or
Free Post: Free Post, KZN 298, Umhlanga Rocks, 4320
What other evidence/documentation is there and where can this be found?
Do you have any further information that could assist to resolve this matter?
Future Reference
If you provided your cellphone number, you should receive a sms when the concern has been addressed. Otherwise you can contact us from time to time to obtain an update.
