Please note:

  1. Signature is required for all application forms.
  2. Please print and sign on the hard copy after clicking on the ‘Submit’ button.
  3. You may proceed to fax/ email/ mail the completed form to our office.

Alternatively, you may print a blank form and complete them manually here.

  • Please provide a clear copy of the front and back of your NRIC/FIN for verification.
  • (please provide details on nature of the complaint relating to the collection, use and/or disclosure of your personal data – state what, when, by whom and/or how)

  • (please list down and provide the relevant documents, if any)

  • CONSENT TO PROCEED

      a) I declare and confirm that the personal data that I have provided on this form is accurate and complete.

      b) I consent to the collection, use and disclosure of the data for the purpose of investigating, responding and handling this complaint.

      c) I enclose my proof of identity.

      d) I understand that Police Co-op may contact me to obtain further information or seek clarifications in order to process my complaint.