Complainant's Registration Form
Fields marked with the asterisk (*) are mandatory

Complainant’s Name* Mobile No*
Office Contact No* Landline No
Residence Contact No Fax No
Address* Email ID*
City* Pin code*
 
Respodent Details
 
Respondent’s Name of Company* Mobile No*
Office Contact No Landline No
Residence Contact No Fax No
Address * Email ID *
City* Pin code*
 
Summary Dispute Details covering:
a. History of case with self attested copies
b. Point of Disagreement with Respondent



You are required to pay a fee of Rs. 500 by Cheque/ DD in favor of REDCO Haryana at DTP Office for processing the case. You are required to give an undertaking as below at the DTP office at the time of payment of fee.

Undertaking:
I undertake to abide by the ruling of the Gurgaon Arbitration Council (GAC)
Please tick one:
I state that the following Police Complaints/ Court Cases are concurrently going on with respect to this case

I state that there are No Police Complaints/ Court Cases concurrently in this case

I will accept the award of Arbitration Council as final and will not seek recourse to any other Legal/ Quasi Legal forum and withdraw any existing Police Compliant / Court Case.
 
Signature of Complainant: