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Complaint Submission Form
Clear identification of the advertisement will enable speedy processing of your complaint.

Your Contact Information

Name
Street Address
Suburb
City/Town & Post Code
Phone
E-mail Address

Advertisement

Where and when did you see the advertisement?
Type of advertisement
Where/when did you see/hear the advertisement?
If the advertisement was on TV or Radio, please include the time and date of broadcast and station. If it is a print advertisement please include the name of the publication, if an outdoor advertisement please include the location and if a website please include the address. If possible please attach a copy of the advertisement below, or post it to us.
Attachment 1
Attachment 2
Who were the advertisers and what product or service were they advertising?
Who
Product

Complaint

Your Complaint

Outline your objection to the advertisement and the basis for complaint.


Fields marked in red are required and must be filled in.

Please ensure that you have provided all the relevant details requested before you submit your application by pressing the 'Submit' button below.

If you are able to send a hard copy of the advertisement please post it to:
Advertising Standards Complaints Board, PO Box 10675, Wellington

I would like to receive a printed copy of the ASA Codes of Practice booklet in the mail.
Or you can read the Codes online by clicking on the Codes Booklet(PDF) in the Codes section of the menu to the left.

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Advertising Standards Authority New Zealand, PO Box 10-675, Wellington 6143. PH (04) 472 7852 FAX (04) 471 1785 Email asa@asa.co.nz