CUSTOMER COMPLAINT FORM
CONTACT DETAILS Surname: ________________________________ Given Names:_________________________________ Postal Address: ______________________________________________ Postcode: _________________ Telephone No: (Home)____________________________ (Business):_____________________________
NATURE OF COMPLAINT (Please refer to information overleaf) Please tick one Ordinary Complaint – A complaint expressing dissatisfaction with a response from Council in regard to a prior request for service or the performance of a staff member, or other contact with a staff member, (excluding serious complaints). Serious Complaint - A complaint against a Councillor or member of staff, which alleges criminal acts, corrupt conduct, improper use of position, breach of pecuniary interest provisions or maladministration and serious waste of resources, or activities referred to in the Protected Disclosure Act 1994, Independent Commission Against Corruption Act 1998 or Council’s Code of Conduct. DETAILS OF COMPLAINT I request that you investigate the following complaint:
______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________
(Please attach additional information if necessary)
Applicant’s Signature: ___________________________________
Date: _______________________
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Request for Investigation of Complaint
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Applicants must provide sufficient information to enable an investigation to be made. If you are making a complaint on behalf of another person, you must submit a written and letter of consent or completed complaint form signed by that person. Council on receiving a complaint may advise a complainant to direct the application to another agency and or refer it onto another agency as appropriate.
The following are NOT complaints under this policy A complaint may include matters related to Councillors, Council staff, regulations, services, policies or procedures, but this policy specifically does not include or cover the following:
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a request for Council Services a request for information or explanation of policies or procedures or decisions of Council reports of damaged or faulty infrastructure (ie potholes) reports of hazards (ie fallen trees) lodgement of any appeal in accordance with any other legislation, policy, procedure or Council decision disputes concerning neighbours.
Refusal to Process Requests In relation to ordinary complaints, the Public Officer may determine that a complaint will not be investigated if:
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it is considered frivolous, vexatious, not made in good faith or where it concerns a matter which is deemed trivial it involves a matter where an adequate remedy or right of appeal already exists, whether or not the complainant uses the available remedy or right of appeal it relates to specific conduct already before a court, coroner or tribunal it relates to matters under investigation by the Minister for Local Government, ICAC, The NSW Ombudsman’s Office, a Minister of the Crown, a Government Department or the NSW Police Service it relates to a decision or policy of Council it relates to a matter still before the Council and awaiting determination of Council it relates to the appointment or dismissal of any employee or an industrial or staff disciplinary issue it relates to a decision, recommendation, act or omission which is more than one year old it relates to actions or conduct of private individuals it relates to a matter where a complainant has provided insufficient information to investigate the complaint and declines or refuses to provide further information it is found, based upon legal advice or legal privilege to be unable to be investigated it is found to be contrary to law any threat is made against Council or a member of Council’s staff. Note that all instances of threats made against Council staff are immediately reported to Senior staff and by Senior staff, to the NSW Police Service.
Your Privacy Shellharbour City Council respects your privacy at all times. When receiving and processing your complaint we collect personal information about you for the primary purpose of providing you with a high level of customer service and in this instance for investigation of you complaint. For more information please see our Privacy Management Plan on our website www.shellharbour.nsw.gov.au or contact our Privacy Officer on 4221 6111. Information leaflets are also available at all offices and libraries.
Updated: 15 May 2009