Dispute Resolution Form

International Financial Commission Supervisory Authority \Resolving A Dispute \How to File a Complaint/Dispute \Dispute Resolution Form

Before the International Financial Commission Supervisor Authority can consider your dispute, you need to have complained to the financial services provider and given it an opportunity to resolve your dispute. In most cases, it has 14 days to respond.

Action to date

Yes, I have previously lodged or registered this dispute with the International Financial Commission Supervisor AuthorityNo, this is the first time I have lodged or registered this dispute with the International Financial Commission Supervisor Authority

Applicant details

Country of residence
Your Email (required)

First Name (required)
Family name
Phone number

Dispute details

Name of the broker you have a dispute with

Please provide a reference number so that your financial services provider can locate the correct
information
Please describe the nature of your complaint.
Please include as much information as you can, including the type of product involved, the dates the problem occurred, the name, address and telephone number (if you know these) of all individuals and firms involved and a description of the problem (please attach a separate page if you need more space than provided)

Additional Comments

What do you think is a fair and reasonable resolution to the dispute?

If you are seeking payment of a sum of money please provide any relevant calculations of your
claim(s)

Supporting documents

Please attach copies of all documents you have that relate to your dispute. If your financial services provider has written to you about your dispute, please ensure that you provide a copy of its response.

Please do not submit the following information:

Personal ID documents: passports, driver’s licenses or other forms of personal identification
Financial documents: bank statements, debit/credit card details
Login information: usernames or passwords for trading, banking or other accounts

Please note: International Financial Commission Supervisor Authority representatives will never ask you for your personal or financial details in the process of handing client disputes