International Centre for Access to Justice

phone:0703446656

Please give us a short summary of your case or complaint *

First Name *

Last Name *

Email Address *

Phone Number *

Address *

Occupation *

Date of Birth *

Defendant's First Name *

Defendant's Last Name *

Defendant's Contact Information (Optional)

How much are you suing (or planning to sue) for? (e.g. $1000) *

What year did the event or cause of action happen? *

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