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Bureau of Professional Licensing Investigations & Inspections Division Complaint Intake Section P.O. Box 30670, Lansing, MI 48909 Telephone: (517) 3739196 Fax: (517) 2412389STATEMENT OF COMPLAINT
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How to fill out statement of complaint form

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Step 1: Obtain the statement of complaint form from the relevant authority or organization.
02
Step 2: Provide your personal details, such as your name, address, and contact information, at the top of the form.
03
Step 3: Clearly describe the incident or issue you are complaining about. Be specific and provide as much detail as possible.
04
Step 4: If there were any witnesses to the incident, include their names and contact information.
05
Step 5: Attach any supporting documents or evidence that are relevant to your complaint, such as photographs, emails, or receipts.
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Step 6: Sign and date the form to confirm the accuracy of the information provided.

Who needs statement of complaint form?

01
Anyone who wishes to file a formal complaint about an incident or issue may need a statement of complaint form. This could include individuals who have experienced misconduct, discrimination, or any other violation of rights.
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The statement of complaint form is a document used to officially register a complaint or grievance.
Any individual or organization that wishes to file a complaint is required to fill out the statement of complaint form.
To fill out the statement of complaint form, one must provide their contact information, details of the complaint, and any supporting evidence.
The purpose of the statement of complaint form is to document and address grievances or complaints in a formal manner.
The statement of complaint form typically requires information such as name, contact details, nature of complaint, and any relevant supporting documentation.
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