Withdrawal of a Complaint

The fields and sections of the form marked with an asterisk (*) are mandatory.

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1. Attestation and identification of the complaint to be withdrawn

Voluntary withdrawal attestation*

I wish to withdraw a complaint submitted to the AMP. The request for withdrawal is voluntary and does not stem from intimidation or collusive practices.

Withdrawal code (as indicated in the acknowledgement of receipt of the complaint):

2. Identification of the complainant and his representative

Name of the business (person) or group of businesses (persons) submitting the request to withdraw the complaint:*

Name and contact information of the representative, where applicable:

Last name:*

First name:*

Title:

Email:*

Telephone:*

3. Grounds for withdrawing the complaint and attestation of the veracity of the information.

Grounds for withdrawing the complaint:*

Attestation of the veracity of the information*

I hereby attest that all of the information provided in this form is, to the best of my knowledge, accurate.