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DTI Initial Complaint Form
DTI Initial Complaint Form
Control No __________
COMPLAINANT
Name:
(Title/ Prefix) (First Name) (Middle Name) (Last Name) (Suffix)
Address
:
(House/Building No./Building Name) (Street Name) (Barangay)
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Complainant
All personal data collected herein shall be processed according to the principles and provisions of the Data
Privacy Act of 2012 (DPA), its Implementing Rules and Regulations (IRR), and National Privacy Commission
(NPC) issuances.
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(Signature over Printed Name of Authorized Signatory)