I would like to report / complain the following defects
The personal data provided by you below will be used by the Highways Department, relevant Government departments and bureaux for the purpose of facilitating communication between the Government and yourself for activities relating to the complaint or enquiry made by you. Should you refuse to supply the required data, no reply with respect to your complaint or enquiry will be made to you.
I have read and acknowledge the above "Notes about Personal Data".
I agree / disagree to refer my personal contact to other relevant organizations, agents, contractors or consultants for follow-up of this case and direct reply to me.