Personnel Complaint Form Page 2
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1
2LT-107 (Rev. 1/07)
(continued)
NORTH CAROLINA DIVISION OF MOTOR VEHICLES
LICENSE AND THEFT BUREAU
PERSONNEL COMPLAINT FORM
(continuation page)
5.
DETAILS OF THE COMPLAINT
Obtain complainant's written report, if possible and attach. Include date and time of incident(s).
NAME OF MEMBER COMPLETING REPORT
SIGNATURE
DATE
YES
NO
ADDITIONAL PAGES / ATTACHMENTS?
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