Formal Complaint Form – City of Ranson, WV

City of Ranson - Formal Complaint Form

Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Type of Complaint (check one):

Description of Complaint (Please provide as much detail as possible, including dates, times, and specific locations, if applicable):

involved? information, Complaint

Are there any individuals or entities involved?

If Yes, please provide names and contact information, if available:

Desired Resolution (optional):

Acknowledgement & Consent

I hereby acknowledge that the information provided in this complaint is accurate to the best of my knowledge. I understand that the City of Ranson may contact me for further information or to follow up on the resolution of my complaint.

Date / Time

Date

Time