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 Your Complaint

PPI Complaints Form Application

Payment Protection Insurance: Consumer Questionnaire

This application form collects information to include within your PPI Complaints Form Application. Use the appropriate buttons at the end of the application form to proceed or to end your application.Please be aware that some explanatory text is included within the form.

This is stage 1 of 3. Required fields are indicated with an asterisk (*). Please do not use your browser's 'back' button to move back or you may lose some of the information you have already entered.


  • This questionnaire is for consumers to bring a complaint about the sale of Payment Protection Insurance (PPI).
  • It is the standard PPI questionnaire used by most financial businesses as well as by the Financial Ombudsman Service.
  • The questionnaire requests the personal and financial details required to progress your complaint.

  • Please fill in this questionnaire, giving as much information as you can.
  • It may take you some time to fully complete the questionnaire and get your facts together ; although having all the information in one place will allow your complaint to be assessed quicker.

Section A: About you

A.1 Your name and contact details

Your details

Details of anyone complaining with you

A.2 If someone is complaining on your behalf (e.g. a relative or claims manager) please give us their details