Complaint/Request Form

COMPLAINT/REQUEST FORM

Last Name: *

First Name: *

E-Mail Address: *

Phone Number: *

Subject of Concern (Please select) * Custom Work
Bylaw
Other

If you selected 'Other' above, please elaborate:

Date/Time of Incident: *

Location/Address of Incident (if applicable):

Persons involved (if known/applicable):

Details of complaint/request: *

Witnesses & Contact information: (if available/applicable)

Enclosures to be included: (documentation/pictures/etc.) *Please list *

Requested outcome and/or suggestions of resolution: *

I confirm that the information above is being provided to the Rural Municipality of Orkney No. 244 to the best of my knowledge and will be used to investigate the complaint/request internally and potentially with third-parties and that confidentiality may not be guaranteed should the information be requested and/or result in court action.

Date: *

Type your full name: *

Bylaw No. 9/2022
Form 3 – Complaint/Request Form

The Rural Municipality of Orkney No. 244

COMPLAINT/REQUEST FORM

In accordance with Bylaw No. 9/2022: That any concerns that ratepayers are asking Council to deal with at a Council meeting shall be completed on the Complaint/Request Form, Form 3 to Bylaw No. 9/2022

1. Procedure

1.1.1 All concerns and complaints relating to the Rural Municipality of Orkney No. 244 must be completed on the Complaint/Request Form and submitted to the Administrator by hand delivery, mail, fax, or e-mail.

1.1.2 In order for the Complaint/Request Form to be presented to Council at the next regular meeting; the form must be received by the Administrator in accordance with Bylaw No. 9/2022 “Council Procedures Bylaw”.

1.1.3 Should a complaint/request be requested by more than one individual, a delegate must be chosen to file the complaint/request.

1.1.4 A complaint/request will only be accepted and presented to Council at a Regular Meeting if the attached form is signed and completed by the person or delegate filing the complaint/request.

1.1.5 Any decisions or responses made by Council will be provided to the Complainant, in writing, by Administration within ten (10) business days following the Council Meeting.

1.1.6 If there are any witnesses listed on the Complaint/Request form they may or may not be contacted.

1.1.7 At the discretion of Council, the concerns brought forward on the complaint/request form may not be addressed if it has been discussed at a council meeting in the 6 months prior to the form being received.

2. Confidentiality

2.1.1 Confidentiality cannot be assured should the complaint result in court proceedings and or requested through proper channels.