FIRST SCHEDULE
COMPLAINT AGAINST CONSTITUTIONAL APPOINTEE
1. Full name of complainant
*
First Name
Last Name
2. Title of complainant: (Dr., Prof., Mr, Mrs, Miss,etc.)
*
3. Physical Address of complainant
*
Street Address
Street Address Line 2
City
State / Province / District
Postal / Zip Code
3. Physical Address of complainant
*
Street Address
Street Address Line 2
City
State / Province / District
Postal / Zip Code
4. If complainant is a company or other entity such as a nongovernmental organisation, full name of company or entity
5. Full name and title (e.g. company secretary, etc.) of person representing the company or other entity
6. Full Name and title of constitutional appointee in respect of whom complaint is being lodged
7. Date, time and place at which the inability to perform was first observed, misbehaviour took place
8. Full description of the inability to perform or misbehaviour
8. Date complaint lodged
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
9. Please specify how you would like to receive acknowledgement of receipt of your complaint: email: (please provide email address below)
(specify if different from mailing address already provided)
9. Draw Signature
*
Upload Signature
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: