Form Ph048 - Complaint Form
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1
2Complaint Form
Complete this form if you have a complaint about a Department of Housing and Public Works
tenancy or property matter, for example, excessive noise or untidy premises.
Complainant’s details
Name:
Address:
Postcode:
Home phone:
Work:
Mobile:
Email:
Complaint against
Name:
Address:
Postcode:
Note: When making a complaint, please give details of your own experience in relation to the
matter/s you wish to bring to the attention of the department. Issues may include, but are not
limited to, untidy premises, neighbourhood disruptions, personal disputes or situations
warranting police action. If there is insufficient space, please attach additional pages, signing
and dating each page. Also attach any supporting evidence.
Details of complaint.
Signature:
Date:
/
/
1
Page
PH048 (16/01/2015)
Department of Housing and Public Works
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Parent category: Legal