CVC Withdrawal Form

CVC Withdrawal Form

We take the privacy and confidentiality of your information seriously. All information provided to us will be handled with the utmost care, confidentiality, and professionalism.
Full Name

First NameLast Name
Member Number
Email Address

Confirmation Email
Phone Number
Format: 0400 000 000.
Details of Withdrawal

The next couple of questions are to obtain further details about the withdrawal of your complaint.
Please provide details of the complaint you are looking to withdraw
If you would like to provide a reason for why you are withdrawing your complaint, you may do so
Do you declare that you are withdrawing this complaint of your own free will and without the solicitation of inducement by any person?
Do you declare that you no longer wish to proceed with the complaint made?
Do you declare that you understand that by withdrawing this complaint, no further action may be taken and the complaint will be considered as 'Resolved via Withdrawal', and you will be unable to make another complaint regarding the same event?
Please note that if your complaint is of a serious nature, CVC may still continue to deal with the issue on its own accord.
Submission
This form was easy to complete:
Please verify that you are human
Signature approving withdrawal of your complaint

This electronic signature will have the same binding effect as a hand written signature.
Should be Empty:

Details of Withdrawal