Get OR DoJ CSF 01 8643 2012

For more specific information see OAR 137-055-1600. Oregon Child Support office you want to report Describe your complaint here. Be sure to sign and date the form on the next page. Page 1 of 2 - CHILD SUPPORT GRIEVANCE FORM CSF 01 8643 Rev. 01/04/12 Signed Date NOTE Your signature is not required when submitting this form electronically via email.. We realize that sometimes people do not agree with these actions or decisions. However if your complaint is about an action the law says we must do or can do we cannot continue with your grievance using this formal process. We will keep working with you to resolve the issue s. Some examples of issues we cannot address using this formal process include child support order amounts income withholding as required by law and actions taken by other agencies or states. For more specific information see OAR 137-055-1600. Oregon Child Support office you want to report Describe your complaint here. Send Save As Print NOTE This form is compatible with Acrobat Reader v8 or higher. If the Send button doesn t work by opening an email message select Save As to save the completed form locally and then attach it to an email message addressed to constituent. desk doj. state. or. us. Reset Child Support Grievance Form If you have a dispute with a child support office please try to resolve the problem with staff or supervisors in that office before you file a grievance formal complaint. Each local office should have a complaint process for you to use. The child support office cannot discriminate against you for filing a complaint or grievance. If you believe you were treated unfairly or your support case was not handled the right way and you are unable to resolve your complaint through your local office report it on this form* Send the completed form to Constituent Liaison Child Support Program 1162 Court Street NE Salem OR 97301. Your name Daytime Phone Case Name if different Child Support Case Number Address Street City State Zip Code PLEASE READ THIS PART BEFORE FILING A GRIEVANCE The Child Support Program must follow the requirements of federal and state laws when deciding and taking actions. We realize that sometimes people do not agree with these actions or decisions. However if your complaint is about an action the law says we must do or can do we cannot continue with your grievance using this formal process. We will keep working with you to resolve the issue s. Some examples of issues we cannot address using this formal process include child support order amounts income withholding as required by law and actions taken by other agencies or states. For more specific information see OAR 137-055-1600. Oregon Child Support office you want to report Describe your complaint here. Be sure to sign and date the form on the next page. Page 1 of 2 - CHILD SUPPORT GRIEVANCE FORM CSF 01 8643 Rev* 01/04/12 Signed Date NOTE Your signature is not required when submitting this form electronically via email*. Send Save As Print NOTE This form is compatible with Acrobat Reader v8 or higher. If the Send button doesn t work by opening an email message select Save As to save the completed form locally and then attach it to an email message addressed to constituent. desk doj. state. or. us. Reset Child Support Grievance Form If you have a dispute with a child support office please try to resolve the problem with staff or supervisors in that office before you file a grievance formal complaint.