Competition Commission Logo

Form CC 1

About this Form

This Form is issued in terms of section 49B of the Competition Act.

This Form must be completed to the best of your ability, and submitted to the Competition Commission for consideration of your complaint.

If this complaint is lodged by a person other than an individual, please provide contact details of the person authorised to discuss the complaint.

This form is a public record. However, the attached description of conduct, and other information relating to this complaint is not part of the public record unless the Commission refers the complaint to the Competition Tribunal. You have a right to identify information that you believe is confidential by completing Form CC7 and submitting it with this Form.

Contacting the Commission
The Competition Commission
Private Bag X23
Lynnwood Ridge
Pretoria 0040
Republic of South Africa
tel: 27 012 482 9000
fax: 27 012 482 9001
e-mail:ccsa@compcom.co.za

Complaint

To: The Competition Commission

From:

Concerning:

Description of the complaint:


Please attach to this form any relevant documents, as well as a
typed statement describing the conduct that is the subject of this
complaint, including
• the names of each party involved in the conduct;
• the dates on which the conduct occurred;
• a statement indicating when and how you became aware of the
  conduct, and
• any other information you consider relevant.

Is the conduct continuing?     Yes      No


If not, when did the conduct end?

Name and Title of person authorised to sign:
Title: Name:

Authorised Signature: Date:

Print before signing
 
 For Office Use Only: Commission file number: Date filed:
 
 
 
This form is prescribed by the Minister of Trade and Industry in terms of section 21 (4) of the Competition Act 1998
(Act No. 89 of 1998).