1. Complaint Information Full Name: Organization Name: Designation: Membership Status: MemberNon-Member Address: Email Address: Phone Number: 2. Complaint Details Subject of Complaint: Date of Incident / Issue: Details of Complaint (Please provide a clear and concise description of the issue, with relevant facts, names, dates, and reference to any documents): Supporting Documents Attached: YesNo List attached documents (if any): 3. Complaint Against Name of Individual / Company: Designation / Position (if applicable): Nature of Concern: Ethical MisconductNon-Compliance with HDAP/DGTO RulesFinancial IrregularityConflict of InterestOther (Please specify): If other, please specify: 4. Actions Taken (if any) Tried resolving with concerned party? YesNo Explain the outcome: 5. Desired Outcome / Resolution Requested What resolution do you expect? 6. Declaration Signature (Type your name): Date:
