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ERC - Complaints form

To help us deal with your complaints effciently. Please fill in fields marked with an asterisk (*)

National ID *		Please enter national ID
Name *		Please enter Name
E-mail		Pleas enter correct E-mail format
Address		Enter the required information
Region		Please enter Region
Phone number *		Please enter phone number

Service Provider *		Please select service provider
Connection Type *		please select connection type

Have you already complaint to service company ?
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Case Date *	Your browser does not support inline frames or is currently configured not to display inline frames.	Please enter Date
Complaint *		Please enter Complaint
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