Advocacy Community

Service Provider Complaint: Mandate and Agreement


Re: Service Complaint Mandate (Case ID: )

Effective Date:

This document formalises the service complaint submitted to Adhoc Support CIC by the Complainant and sets out the terms of our engagement based on the information provided.


Parties to this Mandate

The Complainant:
Adhoc Support ID:

The Community Advocate: Adhoc Support CIC (UK Company No. 16306685)

Complaint Summary

This mandate pertains to the following complaint submitted by the Complainant:

1. Service Provider Details
Name: (This is a unique reference ID. The full provider name you selected has been securely logged with your case record.)
Address:

2. Service & Agreement Details
Type of Service:
Agreement/Account Number:
Date of Agreement:

3. Complaint Details
Reason(s) for Complaint:
Desired Outcome(s):
Date Fault Detected:
Date of First Contact with Provider:
Method of Contact:

Provider's Response (if any):

4. Impact & Financial Loss
Impact(s) Reported:
Estimated Financial Loss: ()

Reason for Financial Loss (if applicable):

5. Detailed Description of Complaint

6. Evidence Checklist
Types of Evidence User Confirmed They Have:

Note: All uploaded evidence (contracts, invoices, correspondence, photos) has been received and is held securely on file as part of this case record.


1. Mandate and Authorisation

I, , hereby authorise Adhoc Support CIC to act as my non-exclusive representative and community advocate in relation to the matter detailed in my complaint submission.

This authorisation includes, but is not limited to, the power to:
a) Analyse my complaint submission and, where appropriate, aggregate it with similar complaints from other members to identify systemic issues.
b) Communicate on my behalf with the service provider and any relevant third parties (such as ombudsmen or regulators) for the purpose of seeking a resolution.
c) Share aggregated and fully anonymised data derived from my complaint with regulators, academic bodies, and the public to advocate for systemic consumer protection improvements.
d) Initiate or participate in collective community actions, including public advocacy campaigns and liaising with legal partners for potential group litigation, in accordance with the Adhoc Support CIC operational model.

2. Complainant's Declarations

By signing this document, I reaffirm and declare that:
a) The information and evidence provided in my complaint submission are true, accurate, and complete to the best of my knowledge and belief.
b) I understand that providing false or misleading information may jeopardise the handling of my complaint and may have legal consequences.

3. Adhoc Support CIC's Commitments

Adhoc Support CIC commits to:
a) Acting diligently, ethically, and in good faith to represent the Complainant's interests.
b) Handling all personal data in strict confidence and in full compliance with our Privacy Policy and the UK/EU GDPR.
c) Operating on a non-profit basis, with any revenue being reinvested into our community mission as per our legal status as a Community Interest Company.
d) Keeping the Complainant informed of significant developments in their case, where they have consented to receive notifications.

4. Data Processing and Consent

By signing this document, I confirm my explicit consent for Adhoc Support CIC to process all personal data contained within my complaint submission and in this Mandate for the purposes outlined above. This signature, along with its associated audit trail (including my name, email address, IP address, and timestamp), will serve as a permanent record of my consent and authorisation, in accordance with UK and EU e-signature regulations.

I understand I have the right to withdraw this consent and mandate at any time by contacting the Data Protection Officer at dataprotection@adhocsupport.org.


5. Final Acknowledgement & Signature

How to Sign This Document:

  1. First, click on the signature box below that says "Sign Here". This will open a pop-up window.
  2. In the pop-up, choose to either "Draw Signature" with your mouse/finger or "Type In Signature" with your keyboard.
  3. Once your signature appears as you want it, click the "Adopt & Sign" or "Insert Signature" button inside the pop-up.
  4. After the pop-up closes, your signature will appear in the document. To finalize, you must scroll to the bottom-right of the page and click the final blue "Agree & Sign" button.

Leave this empty:

Signature arrow sign here

Signed by Geza Koczian (COO, Adhoc Support CIC)
Signed On: 04/07/2025


Signature Certificate
Document name: Service Provider Complaint: Mandate and Agreement
lock iconUnique Document ID: bec5687c6d7c42a87d915bf234dac10310423203
Timestamp Audit
01/07/2025 1:43 PM GMTService Provider Complaint: Mandate and Agreement Uploaded by Geza Koczian (COO, Adhoc Support CIC) - uk@adhocsupport.org IP 86.12.241.184