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• Authorised Officer Complaints

Authorised Officer Complaint Form

Anonymous complaints:

If you wish to remain anonymous you will need to submit enough information to allow us to consider your complaint. If you are making an anonymous complaint, leave out your personal details.

Complainant contact details

First Name

Last Name

Property name / Location

Address

Postcode

State

VICNSWSAWAQLDACTNTTAS

Phone Number

Email Address

Are you making this complaint on behalf of someone else?

• Yes
• No

Details of the person on whose behalf you are making the complaint

What is your relationship to the person on whose behalf you are making the complaint?

First Name

Last Name

Property name / Location

Address

Postcode

State

VICNSWSAWAQLDACTNTTAS

Phone Number

Email Address

Complaint details

Date and time of incident *

Day 12345678910111213141516171819202122232425262728293031 Month JanFebMarAprMayJunJulAugSepOctNovDec Year 201520162017201820192020202120222023202420252026202720282029 Hour 000102030405060708091011121314151617181920212223 Minute 000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859

Location of incident *

What is your preferred method of communication *

-- Please Select --PhoneEmail

Name of authorised officer? (who are you making the complaint about?)

Summary of conduct complaint *

Details of the conduct complaint (description of what happened)

What outcome are you seeking? (Please indicate what action you think should be taken to resolve your complaint e.g. explanation, further information, written apology etc.)

If you have documentation you would like to provide to support your complaint, please upload

Other information

Do you require an interpreter?

• Yes
• No

Preferred language:

Do you have any special needs we should consider when communicating with you?

• Yes
• No

Please specify: