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| To make a complaint, please print this form out. It cannot be submitted by email as it needs to be signed. Return it to the address at the bottom of the form. | ||||
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COMMISSION FOR LOCAL ADMINISTRATION IN WALES Complaint Form Please use black ink if possible and complete your name in block capitals.When you have filled in this form, send it to the Local Government Ombudsman, Derwen House, Court Road, BRIDGEND, CF31 1BN. |
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Your full name: | |||
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| Title (Mr,Mrs,Miss,Ms./other) : | ||||
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Your address : | |||
| Town : | ||||
| Postcode : | ||||
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HomeTelephone number : Telephone number/ Work : Fax number: |
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Name of council (or authority) complained against : | |||
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What do you think the council did wrong or failed to do? | |||
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What personal injustice have you have suffered as a result of the council's wrong-doing or failure? | |||
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What should the council do to put things right? | |||
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On what date were you first aware of the matter you are complaining about? | |||
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How did you complain to the council, and when? | |||
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If it is more than 12 months since you were first aware of the matter you are complaining about, what are the reasons for the delay in complaining? | |||
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If you have any documents to support your complaint, for example letters from the council, these can be sent to the Ombudsman with this form. Please tick the box if you would like them returned to you. | |||
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| To be signed by the person making the complaint | ||||
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