Complaint Form - Virginia Board Of Accountancy Page 3
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VIRGINIA BOARD
OF ACCOUNTANCY
Complaint Form
Have you filed a complaint or intend to file a complaint with another agency?
Yes
No
If yes, name the agency.
Are there other individuals that can provide supportive testimony to your complaint?
Yes
No
If yes, provide contact information. If necessary, use additional sheets of paper.
Name:
Phone:
Street address:
Is a court case currently in progress regarding the complaint?
Yes
No
Do not know
If yes, provide contact information for the attorney handling the case.
Name:
Phone:
Street address:
ALLEGATIONS OF THE COMPLAINT
Provide details of your allegation (names, dates and other specific information) relevant to your complaint. If
necessary, use additional sheets of paper.
Updated July 2017
Page 3 of 4
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