Fill this form and press the submit button. The data will be transferred into an email. It may look garbled to you but do not change anything. Just press send on your email.

Personal Information

First Name:
Last Name:
Email address:
Postal Code:

Complaint Information

Are you satisfied with the financial industry:	Yes No
Select the type of product for your complaint:	Insurance InvestmentMortgageCredit
Name of company/issuer of product:
Name of product:
Name of advisor if there is one:
Have you registered a complaint with regulator:	Yes No
Is the advisor included in this complaint:	Yes No
Have you suffered a financial loss:	Yes No
Enter estimate of financial loss:
Give a summary of your complaint:
Note: For multiple complaints, submit multiple forms Conditions associated with the complaint: By submitting this complaint, the complainant gives the right to FSCA to use this information in its research and investigations. FSCA shall not share any of the personal information obtained through this form with any organizations without prior approval from the complainant. The complainant however gives the right to FSCA to use the generic and general information of his complaint in the publication of its research, newsletters and press releases. The complainant also agrees to these individual conditions: I agree to be contacted by an investigator of FSCA if FSCA judges that more information is necessary about the complaint. I agree to receive the monthly newsletter of FSCA and any other communications necessary to keep me informed as to the progress in regards to my complaint. The complainant can stop these communications by informing FSCA by email of the cancellation of his complaint.
When finished, click this button to transmit your information: