{"id":24865,"date":"2024-11-12T11:57:49","date_gmt":"2024-11-12T08:57:49","guid":{"rendered":"https:\/\/siaya.go.ke\/?page_id=24865"},"modified":"2024-12-09T21:11:38","modified_gmt":"2024-12-09T18:11:38","slug":"municipal-complaint-request-form","status":"publish","type":"page","link":"https:\/\/siaya.go.ke\/siaya\/municipal-complaint-request-form\/","title":{"rendered":"Bondo Municipality Complaint Request Form"},"content":{"rendered":"<p><div class=\"clear\"><\/div>\n<div class=\"divider-3\"><\/div><div class='w3eden'><!-- WPDM Link Template: Default Template -->\n\n<div class=\"link-template-default card mb-2\">\n    <div class=\"card-body\">\n        <div class=\"media\">\n            <div class=\"mr-3 img-48\"><img decoding=\"async\" class=\"wpdm_icon\" alt=\"Icon\" src=\"https:\/\/siaya.go.ke\/siaya\/wp-content\/plugins\/download-manager\/assets\/file-type-icons\/pdf.svg\" \/><\/div>\n            <div class=\"media-body\">\n                <h3 class=\"package-title\"><a href='https:\/\/siaya.go.ke\/siaya\/download\/bondo-municipality-grievances-redress-management-process\/'>Bondo Municipality Grievances Redress Management Process<\/a><\/h3>\n                <div class=\"text-muted text-small\"><i class=\"fas fa-copy\"><\/i> 1 file(s) <i class=\"fas fa-hdd ml-3\"><\/i> 104.57 KB<\/div>\n            <\/div>\n            <div class=\"ml-3\">\n                <a class='wpdm-download-link download-on-click btn btn-primary ' rel='nofollow' href='#' data-downloadurl=\"https:\/\/siaya.go.ke\/siaya\/download\/bondo-municipality-grievances-redress-management-process\/?wpdmdl=25440&refresh=6a9c7e4b4f9751788640843\">Download<\/a>\n            <\/div>\n        <\/div>\n    <\/div>\n<\/div>\n\n<\/div><\/p>\n<p style=\"text-align: justify;\"><strong><div class=\"clear\"><\/div>\n<div class=\"divider-3\"><\/div>Municipal Complaint Request Form<\/strong><br \/>\n<strong>Instructions:<\/strong> Please complete this form to report any issues or complaints within the municipality. We will review and address your concern as quickly as possible. Kindly provide all required information to assist us in investigating and resolving the issue effectively.<\/p>\n<style id=\"wpforms-css-vars-25450\">\n\t\t\t\t#wpforms-25450 {\n\t\t\t\t\n\t\t\t}\n\t\t\t<\/style><div class=\"wpforms-container wpforms-container-full wpforms-render-modern\" id=\"wpforms-25450\"><form id=\"wpforms-form-25450\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"25450\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/siaya\/wp-json\/wp\/v2\/pages\/24865\" data-token=\"3abaa832b8dc29fdf1ca9755bfc5fb71\" data-token-time=\"1788640843\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Please enable JavaScript in your browser to complete this form.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-25450-field_0-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"0\"><fieldset><legend class=\"wpforms-field-label\">Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-25450-field_0\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][0][first]\" aria-errormessage=\"wpforms-25450-field_0-error\" required><label for=\"wpforms-25450-field_0\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-25450-field_0-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][0][last]\" aria-errormessage=\"wpforms-25450-field_0-last-error\" required><label for=\"wpforms-25450-field_0-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/fieldset><\/div><div id=\"wpforms-25450-field_5-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-25450-field_5\">Phone: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"number\" id=\"wpforms-25450-field_5\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][5]\" step=\"any\" aria-errormessage=\"wpforms-25450-field_5-error\" required><\/div><div id=\"wpforms-25450-field_8-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"8\"><fieldset><legend class=\"wpforms-field-label\">Gender <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-25450-field_8\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-25450-field_8_1\" name=\"wpforms[fields][8]\" value=\"Male\" aria-errormessage=\"wpforms-25450-field_8_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-25450-field_8_1\">Male<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-25450-field_8_2\" name=\"wpforms[fields][8]\" value=\"Female\" aria-errormessage=\"wpforms-25450-field_8_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-25450-field_8_2\">Female<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-25450-field_1-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-25450-field_1\">Email <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-25450-field_1\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][1]\" spellcheck=\"false\" aria-errormessage=\"wpforms-25450-field_1-error\" required><\/div><div id=\"wpforms-25450-field_4-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-modern\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-25450-field_4\">Please select the concerned Municipality <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-25450-field_4\" class=\"wpforms-field-medium wpforms-field-required choicesjs-select\" data-size-class=\"wpforms-field-row wpforms-field-medium\" data-search-enabled=\"\" name=\"wpforms[fields][4]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>- Please select -<\/option><option value=\"Siaya Municipality\"  class=\"choice-13 depth-1\"  >Siaya Municipality<\/option><option value=\"Bondo Municipality\"  class=\"choice-12 depth-1\"  >Bondo Municipality<\/option><option value=\"Ugunja Municipality\"  class=\"choice-11 depth-1\"  >Ugunja Municipality<\/option><\/select><\/div><div id=\"wpforms-25450-field_7-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-modern\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-25450-field_7\">Select the Nature of the Complaint <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-25450-field_7\" class=\"wpforms-field-medium wpforms-field-required choicesjs-select\" data-size-class=\"wpforms-field-row wpforms-field-medium\" data-search-enabled=\"1\" name=\"wpforms[fields][7]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>-Please Select-<\/option><option value=\"Service Quality &amp; Delivery Issues\"  class=\"choice-1 depth-1\"  >Service Quality &amp; Delivery Issues<\/option><option value=\"Billing and Payment\"  class=\"choice-3 depth-1\"  >Billing and Payment<\/option><option value=\"Customer Service\"  class=\"choice-4 depth-1\"  >Customer Service<\/option><option value=\"Policy and Procedure\"  class=\"choice-5 depth-1\"  >Policy and Procedure<\/option><option value=\"Communication\"  class=\"choice-6 depth-1\"  >Communication<\/option><option value=\"Contractual Issues\"  class=\"choice-7 depth-1\"  >Contractual Issues<\/option><option value=\"Security Concerns\"  class=\"choice-8 depth-1\"  >Security Concerns<\/option><option value=\"Employment-related Issues\"  class=\"choice-9 depth-1\"  >Employment-related Issues<\/option><option value=\"Environmental and Climate Change Concerns\"  class=\"choice-10 depth-1\"  >Environmental and Climate Change Concerns<\/option><option value=\"Health and Safety\"  class=\"choice-11 depth-1\"  >Health and Safety<\/option><option value=\"Ethical Concerns\"  class=\"choice-12 depth-1\"  >Ethical Concerns<\/option><option value=\"Social Issues\"  class=\"choice-13 depth-1\"  >Social Issues<\/option><option value=\"Others...\"  class=\"choice-14 depth-1\"  >Others...<\/option><\/select><\/div><div id=\"wpforms-25450-field_2-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-25450-field_2\">Please provide a brief summary of your complaint and attach all supporting documents.  <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-25450-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" aria-errormessage=\"wpforms-25450-field_2-error\" required><\/textarea><\/div><div id=\"wpforms-25450-field_6-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-inline\" data-field-id=\"6\"><fieldset><legend class=\"wpforms-field-label\">Acknowledgement:   All the information provided above is true and correct to the best of my knowledge  <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-25450-field_6\" class=\"wpforms-randomize wpforms-field-required wpforms-image-choices wpforms-image-choices-modern\"><li class=\"choice-1 depth-1 wpforms-image-choices-item\"><label class=\"wpforms-field-label-inline\" for=\"wpforms-25450-field_6_1\" tabindex=\"0\"><span class=\"wpforms-image-choices-image\"><\/span><input type=\"checkbox\" id=\"wpforms-25450-field_6_1\" class=\"wpforms-screen-reader-element\" name=\"wpforms[fields][6][]\" value=\"YES\" aria-errormessage=\"wpforms-25450-field_6_1-error\" tabindex=\"-1\" required ><span class=\"wpforms-image-choices-label\">YES<\/span><\/label><\/li><\/ul><\/fieldset><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-recaptcha-container wpforms-is-recaptcha wpforms-is-recaptcha-type-v2\" ><div class=\"g-recaptcha\" data-sitekey=\"6Lfy1pgpAAAAAN_s0G8SgaKvyyrO5qTjIjOoXS9j\"><\/div><input type=\"text\" name=\"g-recaptcha-hidden\" class=\"wpforms-recaptcha-hidden\" style=\"position:absolute!important;clip:rect(0,0,0,0)!important;height:1px!important;width:1px!important;border:0!important;overflow:hidden!important;padding:0!important;margin:0!important;\" data-rule-recaptcha=\"1\"><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"25450\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/siaya.go.ke\/siaya\/wp-json\/wp\/v2\/pages\/24865\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-25450\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><img decoding=\"async\" src=\"https:\/\/siaya.go.ke\/siaya\/wp-content\/plugins\/wpforms-lite\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container -->\n","protected":false},"excerpt":{"rendered":"<p>Municipal Complaint Request Form Instructions: Please complete this form to report any issues or complaints within the municipality. We will review and address your concern as quickly as possible. Kindly provide all required information to assist us in investigating and resolving the issue effectively.<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"om_disable_all_campaigns":false,"footnotes":""},"class_list":["post-24865","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/siaya.go.ke\/siaya\/wp-json\/wp\/v2\/pages\/24865","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/siaya.go.ke\/siaya\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/siaya.go.ke\/siaya\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/siaya.go.ke\/siaya\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/siaya.go.ke\/siaya\/wp-json\/wp\/v2\/comments?post=24865"}],"version-history":[{"count":0,"href":"https:\/\/siaya.go.ke\/siaya\/wp-json\/wp\/v2\/pages\/24865\/revisions"}],"wp:attachment":[{"href":"https:\/\/siaya.go.ke\/siaya\/wp-json\/wp\/v2\/media?parent=24865"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}