Smmusd Form: Complaint Against An Employee Page 2

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What were the results of those discussions?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
What is the remedy that you desire regarding this complaint?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
I (we) understand that the supervisor of the employee, the Assistant Superintendent, or the Board
of Education may request from me (us) further information about this complaint, and if such
information is available, I (we) shall present it upon request.
I (we) also understand that a copy of this complaint will be given to the person(s) against whom
the complaint is made, and he/she/they will be given the opportunity to respond in writing to this
complaint.
I (we) certify under penalty of perjury that the foregoing is true and correct.
Executed this ____ day of ______________, 20__, at _________________________,
California.
Signatures:
________________________
________________________
________________________
________________________
Note: If the complainant is not satisfied with the response of the supervisor, he/she/they may
appeal to the SMMUSD Superintendent.
2
SMMUSD Form: Complaint Against an Employee (BP 1312.1)

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