Table of Contents

Grand Jury Citizen Complaint Form

 

GRAND JURY CITIZEN COMPLAINT FORM

 

TO:                                                                  DATE: _____________

Amador County Grand Jury
P.O.  Box 249
Jackson CA  95642

ð        READ OTHER SIDE OF PAGE BEFORE FILLING OUT THIS FORM

1.         This complaint is against:  

Name, Title:

Organization:

Address:

Phone:

 1.         My complaint against the above is: 

 

 

 

 

 1.         Before filling out this form I have contacted: 

 

 

 

 1.      Complainant: 

Name:

Address:

Phone:

 1.      I request the following action: 

 

 

 

 

  

The information in this form is true, correct, and complete
to the best of my knowledge. 

 

 (Signature)

 

ALL COMMUNICATIONS TO THE GRAND JURY
ARE CONFIDENTIAL

 

(back side of Complaint Form)

  

GRAND JURY CITIZEN COMPLAINT FORM

CITIZEN COMPLAINTS: 

The Grand Jury is empowered to investigate complaints from citizens, civic groups, government employees, and others, about the workings of local governments, prisons/jails, some private non-profit organizations, certain schools and school districts, and other organizations, and the conduct of their officers and employees.  The Grand Jury is the guardian of public trust in local government and the proper use of public funds. 

CONFIDENTIALITY: 

In all its proceedings and investigations the Grand Jury is sworn to maintain complete secrecy.  The members of the Grand Jury apply the same objective standard of conduct and responsibility to all persons and entities, and are not influenced by sentiment, conjecture, sympathy, public feelings, passion, or prejudice. 

COMPLAINT PROCESS: 

The Grand Jury investigates complaints presented to it in any form, but it is desirous that this form is used whenever possible.  Please identify the specific problem and describe the circumstances.  Present your complaint with all available evidence and submit copies of all available documents.  The Grand Jury will acknowledge receipt of your complaint.  Mail this complaint form to: 

                        Amador County Grand Jury
                        P.O.  Box 249
                        Jackson CA  95642

INSTRUCTIONS FOR COMPLETING FORM:

1.       This complaint is against: Give as much information as possible to locate the person or organization.

2.       My complaint against the above is: Describe the problem in your own words.  Be concise, provide dates, times, and names of individuals involved.  Cite specific instances as opposed to broad statements.  Attach photographs, correspondence, or documentation that support the complaint.  If a longer explanation is necessary attach extra sheets and show the number on the last line of the first sheet (i.e.  3 additional sheets attached.)

3.      Before filling out this form I have contacted: Attempt to correct the problem before contacting the Grand Jury and explain what you have done in that regard so that we do not repeat the same steps you have taken.

4.      Complainant: Please tell us how we may contact you for further information, if necessary.  Your confidentiality will be rigorously protected.

5.       I request the following action: The Grand Jury will acknowledge receipt of your complaint and may advise you whether or not an investigation will be undertaken.  If the Grand Jury feels your issue is not within its jurisdiction we will so advise you.

 

ALL COMMUNICATIONS TO THE GRAND JURY
ARE CONFIDENTIAL