Enhanced Supplementary Labour Scheme Complaint Form

Complaint Referral Form

Details of complaint:

Date of complaint:
Name of employer: ★
Workplace address: ★
Name of complainant:	Not willing to disclose
Please provide us with your personal information/contact details as far as possible so that the Labour Department (LD) can follow up on your complaint effectively. Please note that if insufficient information is provided, LD may not be able to process your complaint.
Identity of complainant: ★
Contact number:
Email address:
Job title:
Employment status:

Major complaint matters:

★

Please select the area(s) of complaint and provide relevant details.

Wage-related Statutory holidays, annual leave and rest days Working hours Work arrangements (e.g. change of duties and workplace) Accommodation Displacement of local workers by imported workers (including the manning ratio between local employees and imported workers) Others (please provide relevant information in “Details of complaint”)
Details of complaint:

Personal Information Collection Statement
The personal data collected in this form is used by the Labour Department (LD) for the purposes of assessing employers’ applications under the Enhanced Supplementary Labour Scheme (ESLS), enforcing the requirements of ESLS, and enforcing the Employment Ordinance and other legislation administered by LD. The relevant information may also be used for the enforcement of relevant laws/ regulations by other government bureaux and departments. The personal data provided may be disclosed to other government bureaux and departments for the purposes mentioned above. You have the right of access and correction with respect to your personal data as provided under the Personal Data (Privacy) Ordinance. If you wish to access and correct your personal data, please make such requests to the Divisional Personal Data Privacy Officer of Supplementary Labour Division of LD (address: Units 2711-2713, 27/F, Tower 1, Millennium City 1, 388 Kwun Tong Road, Kwun Tong, Kowloon).
I acknowledge and understand the above “Personal Information Collection Statement”. ★

Declaration:
Are you willing to provide further information about the case to the Labour Department to facilitate our investigation in the future?
Yes (Please ensure you have provided your name and contact means)	No
Do you agree the Labour Department to disclose your identity and information during our investigation to the employer being complained?
Yes	No
Do you request a reply from the Labour Department?
Yes	No

Authentication Code:

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Note: ★ Mandatory fields