Sample complaint form by FKij3B

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									Sample complaint form

This section to be completed by the person making the complaint

If you have any queries about filling in this form or need it in a different format or
language, please contact OCPA at telephone: 020 7276 2625 or e-mail: enquiries@
publicappointmentscommissioner.org Please ensure that you have read the
Commissioner’s Guide to Making a Complaint about a Public Appointments Process
before you fill in this form.

Please use block capitals and sign the form at the end.

From:

Name

Address



Postcode

Home Telephone Number

Daytime Telephone Number

E-mail

Please indicate how you would like us to contact you by ticking the boxes:

Letter

E-mail

Other (please specify)

Please insert details, including name of public body and position (e.g. Chair).

When did the public appointments process end, so far as you
are concerned?

(Please insert the date of any letter informing you of the outcome of the appointments
process or other relevant information.)
The Commissioner will only investigate a complaint after you have complained to the
Government department or other organisation responsible for the public
appointments
process concerned and you have received a response to your complaint. This will
give
the Government department or other organisation a chance to put things right.

Have you complained to the Government department or other
organisation
which was responsible for this public appointments process?

Please tick the relevant box:

Yes, I have complained
(If you have answered “yes”, please send a copy of your complaint with this form.)

No, I have not complained because            (please give your reason)




Has the Government department or other organisation sent you
a substantive response to your complaint?

Please tick the relevant box:

Yes
(If you have answered “yes”, please send a copy of the response with this form.)

No

If you have not been able to identify the Government department or other
organisation
which is responsible for the public appointments process about which you wish to
complain, indicate below ……..

What is your complaint?

Please set out below a summary of your complaint. Describe what you believe has
gone wrong.

Please continue on a separate sheet of paper if necessary.
What in your view would resolve your concern or concerns?

Please tick the relevant box(es)

       an assurance that the appointments process which is the subject of your
       complaint has been conducted in accordance with the Commissioner’s Code
       of Practice.

OR

       an apology

       an explanation

       an assurance from the organisation responsible for the appointments process
       that the same thing will not happen again

       action that can be taken to put things right.

Information to support your complaint

Please send any evidence you have which is relevant to your complaint.




Declaration:

I consent to the Commissioner or a member of her office (“OCPA”) making enquires
of any person or bodies for the purpose of investigating my complaint and I authorise
any such person or bodies to provide and deliver any information, documents, files
or related papers required by the Commissioner or OCPA in order to investigate my
complaint.

Please tick the relevant box YES              NO

Signature                      Date

								
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