Applicant/Resident Grievance Or Complaint Form

APPLICANT/RESIDENT GRIEVANCE OR COMPLAINT FORM

____________________________________ Apartments

Dear Applicant/Resident: All grievances or complaints must be submitted in writing to the Management Office. Please write your grievance clearly and thoroughly so that Management may address your concerns in a timely manner. Please be sure to sign and date the form before returning it to the Management Office. Once you have returned the form, please make an appointment with the Property Manager, ____________________________, to discuss the issue. If you have any questions or concerns regarding the completion of this form please call the Management Office at ( ) .

Applicant/Resident Name: __________________________________________________________

Date of Grievance or Complaint:_________________ Apt. #: (If applicable)_________________

Grievance/Complaint:______________________________________________________________

_____________________________________________________________________________

SIGNATURE:

The information you give is confidential. Your signature below will give us permission to use this document as evidence if legal action is required to resolve your grievance. Please check the appropriate line: ___ I am ___ I am not willing to testify in court.

Applicant/Resident Date

Form Accepted by: Date: ___________________

Appointment Date: ______________ With Whom: _____________________________________

Action Required: Date: ___________________

Follow-up Action: _____________________________________ Date:____________________

Issue Resolved by: ____________________________________ Date: ___________________

Submitted to Regional Property Supervisor: Date:_____________________________________

Additional Comments: ___________________________________________________________

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Grievance/Complaint Form (7/02) Revised 3/2008 1of 1 MO-16