Financial Services 5160 Yonge Street Commission Box 85 of Ontario Toronto, Ontario M2N 6L9 COMPLAINT HANDLING PROTOCOL FORM Company Name Company Licence Number (For FSCO use) COMPANY/OMBUDSMAN LIAISON REPRESENTATIVE (This name will be given out on request) Name Titles Company Address City Province Postal Code Telephone Number Area Code Fax Area Code (direct line) Number Third party mechanism for complaints remaining unresolved at the company level CLHIO GIO OBSI (If you use more than one FSON Ombudservice, please attach a note indicating which complaints go where) OIO/FSCO Other. Please specify ___________________________________________________________________________ The company has a complaint Protocol that has been communicated to all staff, adjusters and distribution systems. Information about the Protocol is readily available to consumers upon request. Signature of Officer Year Month Day Date Title of Officer Note: Please notify the Ombudsman Services Branch of any information changes 372-om-i-e1-protocol Ce formulaire est également disponible en français.
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