Workplace Complaints Form - Australia
Workplace
Complaint Form
IMPORT
ANT: If your complaint relates to unfair dismissal or termination of your employment, please contact the Fair Work
Infoline IMMEDIA
TELY on 13 13 94. Please note: All questions marked with an asterisk (*) are mandatory.
Please complete this form using black ink.
Fair Work Ombudsman ABN 43884188232 www.fairwork.gov.au
Page 1
Section 1. Complainant details
1.1 Title*
Mr Mrs Ms Miss Dr Other
1.2 Surname/family name*
Given name/s*
1.3 Postal address*
Subur
b/town
1.4
Daytime contact number*
1.5
Email address
1.6 Dat
e of birth
1.7 Do you need an interpreter?*
State
Postcode
Mobile number
D D
M M
Y Y Y Y
Yes No Language
For an interpreter,
contact Translating &
Interpreting Services
(TIS) on 13 14 50
No – Please continue with section 2 Yes
Yes No
1.8 Has someone else completed this form on your behalf?*
1.9 D
o you authorise this person to act on your behalf?
Contact name
Contact number
Page 1/5
Free Download
Workplace Complaints Form - Australia PDF
Favor this template? Just fancy it by voting!
(0 Votes)
0.0
Related Forms
