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Ombudsman WA Complaint Form

Z Serving Parliament - Serving Western Australians Ombudsman Western Australia Complaint form Revised October 2018 Please use this form to make a Complaint about a State Government department or agency, local government or university. For information on what you can and cannot complain about go to How to make a Complaint on our website at or contact us on (08) 9220 7555 or 1800 117 000 (toll free from landlines) for assistance. The information you provide will only be used for the purpose of assessing and investigating your Complaint . What State Government department or agency, local government or university are you complaining about? Your contact details Name Title: Given name/s: Surname: Mailing address Street or PO Box: Suburb: Postcode: Telephone Home: Mobile: Work: Email Do you want someone to help you with your Complaint ?

z . Serving Parliament - Serving Western . Australians . Ombudsman Western Australia . Complaint Form. Revised October 2018 . Please use this form to make a complaint about a State Government department or agency, local government

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