|
�
<br /> . w
<br /> CITIZEN COMPLAINT WORhSHEET
<br /> .
<br /> �.
<br /> Date: / • �I� ' gj�p Taken by: �� v.� L����� �
<br /> Complainant's name: �� � �,��,�,� ,J ��
<br /> Complainant' s address: � 2�/ �,�ZQ,o�GU.� ,✓
<br /> �
<br /> Complainant 's phone: �j 3 9— / 'S 2 7 �
<br /> � t;
<br /> Complaint concerning: %��/'/ �L �j/Zp,dpWpy �;'
<br /> Problem:_ �,BQT/E5 L !U/,vL. l�J /F1�dG/G /17 /��/ �Z �
<br /> �32�eowe� — �r�u���� ��,,s �ua ,�u�� ��--y; :
<br /> s
<br /> �2 /-�.��T- 17u�n.o�i�4 rv�s� �.tJ ,P�� Y ,� [,
<br /> E
<br /> s
<br /> i
<br /> �Gl,,(./E� �Q� /��GY*��7� {
<br /> /$�1G2(1,r.1.t� �,tJ.e j�, �.
<br /> �7T' �.
<br /> f-
<br /> 590 Z �L �o S T,v j✓-T N�✓ ;
<br /> 7.��t/GUb'iO.o, �f�Z�Z
<br /> f��& l�'2 - 97/�
<br /> Referred to: �,,�/2/,�J/,./ p,Q ;��,,,�� �,
<br /> �
<br /> AC'_'Z0� TP.I:Eti
<br /> -�i- a � � G �G�4 �- . - u �
<br /> � ' �.
<br /> t — , �' % � .
<br /> i . � , �•
<br /> � a �
<br /> n .,L.. �
<br /> - ,u-rtiC�!�..�-/� �.
<br /> i�
<br /> i -
<br /> � �l.-L �
<br /> �. � �(/`C � +�
<br /> �— --�� �C. �.
<br /> .l�C c�,i'� /�� � � � � . �� ;i.
<br /> r _ .,�"�'�A �, a, .�t .' i ��d �i7 ✓ v M
<br /> . JC 1 w_ ..M�? T //!`—v`-'ee�l.s�o_,r.� /J t�..f� (��` �
<br /> �1L.<Y�� ♦,�w� �
<br /> /�A ,,, JA� o �//A / �J /1 /�� }
<br /> ✓!'� //� �/YE�� /J iLl�F�6c-�-A/C�- -C�..�. ��lLf/'9i/��d[ �G�C�L�". � ;
<br /> n � / �1 � � � J �
<br /> �u-,.�-(�Cl�• o�% �/�,-�-y .n-kr-7...z_ l�,.-Y,�'/ �..*-u�..��-.L / i�.
<br /> / �t�L e.
<br /> �/�1 . v��'!C-�L-L�I-� ./`Y" '"{/.L�. t.
<br />
|