COMPLAINT FORM

COMPLAINANT’S PARTICULARS

Mrs
Title: _____

Dikgabiso
Full Names: ______________________

Sobantu
Surname: ___________________________

9011150742086
ID NUMBER: ____________________________________

GENDER:

Male|Female
X
Age

16 -24|25 -34|35 – 44|45 – 54|55 – 65|65+

X
Bookkeeper
Occupation:______________________________

Physical Address:
____________________________________________________________
6 Reve De Provence
____________________________________________________________
121 Hornbill Rd
____________________________________________________________
Douglasdale
Sandton
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________

Sandton
City:_________________________
2191
Postal code:_________

Postal Address :
____________________________________________________________
P.O. Box 2741
Northriding
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________

Randburg
City:_________________________

2162
Postal code:_________

Telephone no (w):__________________
Telephone no (h):_____________________

0828389002
Cell no :_____________________________

Fax no:______________________________
deco1511@gmail.com
Email Address:_________________________

How did you learn bout Consumer Affairs?

X
Radio|Television|CAOW|Newspaper|Friend/Relative|other(specify)

RESPONDENT’S PARTICULARS

KFC South Africa

Business Name : _____________________
Physical Address:
Building G
____________________________________________________________
Knightsbridge Office Park
____________________________________________________________
33 Sloane Street
____________________________________________________________
Bryanston
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________

Sandton
City:_________________________

2191
Postal code :_________

0860100222
Telephone no (w):__________________

Fax no:______________________________

Cell no :_____________________________

kfccustomercare@dsg.co.za
Email Address:_________________________

KFC SA
Trading Name: _______________________

Physical Address:
Building G
____________________________________________________________
Knightsbridge Office Park
____________________________________________________________
33 Sloane Street
____________________________________________________________
Bryanston
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________

Sandton
City:_________________________

2191
Postal code :_________

City:_________________________

Postal code :_________

Telephone no :__________________

Fax no:______________________________

Cell no :_____________________________

Email Address:_________________________

BRIEF OUTLINE OF COMPLAINT

____________________________________________________________
On the 15th of July 2022, I placed an order for lunch on the KFC
____________________________________________________________
online. On the first attempt to pay for the order online, there
____________________________________________________________
appeared to be a glitch which then prompted me to make another
____________________________________________________________
Payment because the first one was unsuccessful. The same thing
____________________________________________________________
happened again when i got to the payment screen, only to realize
____________________________________________________________
That even though KFC online was having these glitches when it
____________________________________________________________
took payments, the money had already been taken off my account
____________________________________________________________
twice. When i called the customer line I was told to wait 15 minutes
____________________________________________________________
for a order confirmation. I eventually received my order, however,
____________________________________________________________
there was still the issue of the other payment that went off. It has
____________________________________________________________
been a struggle to get tgis refunded by KFC. I have called numerous
times and was even allocated two references.
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
________________________________________
____________________________________________________________
__________

Have you paid anything?

X
Yes|No

If yes,how did you pay?

X
Cash|Cheque|Credit Card

The Amount you paid was

X
Full Amount|Part of the Amount

Please indicate which of the following documents you have available

X
Invoice|Receipts|Contract
PLEASE STATE HOW YOU WOULD LIKE THIS MATTER TO BE RESOLVED
____________________________________________________________
KFC needs to refund my account
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________

PLEASE NOTE:

. The office DOES NOT ACCEPT original documents

. Should you send originals ,the office will NOT BE LIABLE for the loss of
the documents

. The office will do it’s utmost best to attend to your complaint promptly.
Should we miss to communicate in any manner within 90 Days of lodging
the complaint ,please feel free to contact the office.

29 July 2022
Date: _________________________

Signature __________________________

Department of Economic Development

CONSUMER AFFAIRS

Private bag X091. Marshalltown. 2107

Tel No: (011) 355-8006

Fax No: (011) 355-8019