Regulations Governing the Establishment, Supervision and Management of Telecommunications Dispute Resolution Institutions Article 23

To apply to institution a mediation case, a telecommunications consumer shall fill in an application form that expressly stating the name and basic information of the party to the dispute,the claim, the fact, the reason, and the details regarding the inappropriate handling of the dispute.
中文原文 電信消費爭議處理機構設立與監督管理辦法第23條
電信消費者申請調處,應填具申請書,載明當事人名稱及基本資料、請求標的、事實、理由及申訴未獲妥適處理之情形,並檢具相關文件或資料。

English translation for reference only; the Chinese text prevails. Not legal advice.