Persons are not required to respond to a collection of information unless it displays a currently valid OMB control number. Pursuant to 29 CFR § 37.37(c), completing this log is required to …

To help you with your tracking needs, we have included worksheets for a non-discrimination complaint log and MSFW complaint log, optional forms that you may elect to use or from which …

Date Complaint Received. Service Connection Address. Customer Name. Customer Phone Number. Customer Email Address. Description of Problem. Date Corrective Action Completed. …

(Note: If the firm received authorization from the customer subsequent to the receipt of a third party/anonymous complaint, it is obligated to file an amendment via the Firm Gateway …

To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary …

A COPY OF THIS COMPLAINT MUST BE FILED, IN TRIPLICATE , WITH THE COUNTY BOARD OF TAXATION AND THE OWNER OF COMPLAINT WILL BE SENT BY THE …

Supplier Name Product/Service Description of Complaint Complaint Type Reported By Contact Information Assigned To

Please send form to: COMPLAINT/INCIDENT INFORMATION COMPLAINT/INCIDENT DESCRIPTION: HST Complaint/Incident Form

To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: …

Complaint/appeal process not explained, lack of adequate or understandable NOA Member denied access to medical records (other than as restricted by law) Did not respond to …