Providing your contact details is optional but it might be helpful if the service needs to contact you for more information.
Any details provided on this page will only be used in relation to this case.
Ticking this box will save these details in your browser (in one of those cookie things). This just means you won't have to type them in again next time you visit this page.
If you un-tick the box the details will be removed from your browser when you click submit.
DGC Fault Reporting Application | Version 2.5 | Last build 17/02/2023