GENERAL COMPLAINT, CONCERNS COMMENTS FORM
Torrey Town
Name___________________________ Today’s date____________________________
Person receiving complaint:_________________________________________________
By: Letter Phone Visit Other.
Address of Complainant: ___________________________________________________
Phone of Complainant: _____________________________________________________
Ø Nature of Concern/Comment:
Please write a brief paragraph:
Ø Complaint
Date of Incident___________________________________________________
Brief Description of complaint. Including address of problem, department responsible any pertinent
facts.
Please list any names if needed and location
All complaints or concerns must be filed with the town in order for the council to take any action if it is
necessary. It is possible that the person receiving the complaint may ask who issued the complaint.
Signed___________________________________________________________Date_____________
Filed with the town on: Date_____________________________
Clerk Signature_________________________________________
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