Full Text
Complaint submitted to: Name of complainant: Date complaint first discussed with immediate supervisor or elected official: Department in which employed: Date this written complaint Is submitted: Classification: Date and time complaint occurred: Location where complaint occurred: Description of incident giving rise to the complaint: (attach additional sheet if necessary) County ordinance or resolution, personnel regulations, applicable state law, or policy believed to be violated: Desired remedy which complainant feels will resolve the complaint: All accompanying data and any responses from the previous steps shall be submitted with the original form at all subsequent steps. STEP 1 _ _ STEP 2 Supervisors Signature Date Discussed Date Answered STEP 3 County Manager's Signature Date Discussed Date Answered STEP 4 EEO Officer’s Signature Date Discussed Date Answered Chairman of the Board of Commissioners Signature Date Discussed Date Answered Greene County Complaint Form