ACCOUNT_LAST_NAME ACCOUNT_FIRST_NAME

ACCOUNT_JOB_ADDRESS_SINGLE_LINE

ACCOUNT_EMAIL

A Complaint against a Government Department / Official’s Conduct

Government Department Name: GOVT_DEPT_NAME

[City / Region / Country]

Date:  25 November 2024

Particulars of the Complainant

Name: ACCOUNT_FIRST_NAME ACCOUNT_LAST_NAME

Correspondence Address: ACCOUNT_JOB_ADDRESS_SINGLE_LINE

E-mail: ACCOUNT_EMAIL

 

Details of the Complaint

Name of Government Official Involved: GOVT_OFFICIAL_NAME

Name of Government Unit: GOVT_UNIT_NAME

Date of the Incident: INCIDENT_DATE

[Case No.: (if applicable) [Number]]

Complaint Details:

[Provide details of the complaint and the requested action from the ombudsman office.] 

........................................