COMPLAINT FORM

Information for complainants.<br /> A complaint should only be lodged if you have been unable to resolve your issues informally. Complainants may be contacted and asked to provide additional information to support their<br /> complaint

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Name *

First

Last

Phone: *

Gender *

• Male
• Female

Email *

Please select the concerned Department/Municipality *- Please select -Governance , Administration & ICTFinance & PlanningAgriculture , Livestock & FisheriesEnterprise DevelopmentTourism, Culture, Sports & ArtsHealth & SanitationEducation, Youth , Gender & Social ServicePublic Works, Energy, Roads and TransportWater, Irrigation, Environment, Climate Change & Natural ResourcesLand, Physical Planning, Housing and Urban DevelopmentSiaya MunicipalityBondo MunicipalityUgunja Municipality

Select the Nature of the Complaint *-Please Select-Service Quality & Delivery IssuesBilling and PaymentCustomer ServicePolicy and ProcedureCommunicationContractual IssuesSecurity ConcernsEmployment-related IssuesEnvironmental and Climate Change ConcernsHealth and SafetyEthical ConcernsOther

Please provide a brief summary of your complaint and attach all supporting documents. *

Acknowledgement: All the information provided above is true and correct to the best of my knowledge *

• YES

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