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Ombudsman Tasmania
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Ombudsman Tasmania
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Ombudsman Complaint Form
Ombudsman Tasmania complaint form
1. Details of the person making the complaint
Title
Mr
Ms
Mrs
Miss
Other
Other Title (Please specify)
Surname
First Name
Address
Suburb
if you live overseas enter "outside Australia"
State
-- Please Select --
TAS
ACT
NSW
NT
QLD
SA
VIC
WA
Outside Australia
Post Code
Telephone
(business hours)
Mobile
Fax
Email Address
Do you have a disability or other special needs?
Yes
No
(please specify)
Are you of Aboriginal or Torres Strait Islander origin?
No
Yes, Aboriginal
Yes, Torres Strait Islander
Yes, both Aboriginal and Torres Strait Islander
Preferred Language
Interpreter Required?
Yes
No
What is your complaint type?
Administrative action
Public Interest Disclosure
Personal Information Protection
Unknown
Are you an International Student?
Yes
No
Not applicable
