Complaint relating to malicious calls

This form is to be returned within 15 days to Mr. Luc Tuerlinckx, Ombudsman :

• by e-mail, scanned to klachten@ombusmantelecom.be ;
• by fax, to number 02 219 86 59 ;
• by post, sent to Koning Albert II-laan 8 bus 3, 1000 Brussels.

NOTE: THIS FORM IS NOT VALID UNLESS SIGNED.