Regulations > Military Ombud Complaints Regulations 2015 > Annexures

ANNEXURE A

CONFIDENTIAL

FORM 1

MILITARY OMBUD COMPLAINT FORM

COMPLAINT IN TERMS OF SECTION 6(2) MILITARY OMBUD ACT 4 OF 2012

(Regulation 3)

UNDERTAKING:

I apply to the Military Ombud to investigate and consider my complaint. All relevant documentation is attached.

1.	I __________________________________, Identity number /Force number _________________________________________declare that my complaint is not relating to:

➢	The manner in which a military judge performs his or her functions in his or her capacity as a judge;

➢	A matter that is pending before a military or civilian court; or

➢	A matter on which a decision has been taken by a military or civilian court.

2.	I understand the Military Ombud may refuse to investigate a complaint if:

➢	An investigation may undermine channels of command or constitute insubordination in the Defence Force;

➢	A complaint is not lodged within the prescribed time-frame.(Kindly attach the application for condonation if the complaint is not within the prescribed timeframe);

➢	A member has not first used the mechanism available under the Individual Grievances Regulations, 2010, unless the complaint relates to problems inherent in the system which bring about an adverse result to the complainant;

➢	A complaint was not lodged within the prescribed timeframe and condonation was not granted; or

➢	A complaint was referred for arbitration, conciliation, mediation or negotiation to another competent tribunal or forum.

3.	I understand and agree that by submitting this complaint:

➢	The complaint and all information contained therein will be treated as confidential by the Military Ombud who will collect, store, process and share my personal information and use the information only in as far as it relates to the investigation and resolution of my complaint;

➢	A finding of the Military Ombud does not affect my legal rights or priviledges; and

➢	Should I not be satisfied with the decision of the Military Ombud, I may apply to the High Court for review against that decision in terms of section 13 of the Military Ombud Act 4 of 2012.

_____________________________	_____________________________________
Complainant Signature	Person authorised to sign on behalf of the complainant (where applicable)

____________________________
Date

Military Ombud Act, 2012 (Act No. 4 of 2012)