Address: Home or Cell Phone #: (Area Code) Street Address City State Zip Name of Warden or Department Head: Respondent Information (Person Complained Against) Name: Title: Date(s) of Discriminatory Event: Are you complaining about: Unit or Dept: Earliest: Latest: Slurs or Hostile Epithets? (Check) Yes No If yes, explain: Color Discrimination? Yes No If yes, identify your color: Race Discrimination? Yes No If yes, identify your race: National Origin Discrimination? Yes No.
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How to fill out the TX PERS 497 online
The TX PERS 497 form is essential for individuals reporting discrimination or harassment within the Texas Department of Criminal Justice. This guide provides clear, step-by-step instructions to assist users in completing the form online with confidence.
Follow the steps to successfully complete the TX PERS 497 online.
- Press the ‘Get Form’ button to access the document and open it in your editing tool.
- Begin by filling in your personal information in the complainant section, including your last name, first name, middle initial, Social Security number, title, unit or department, work shift, schedule card, and home mailing address.
- Provide your contact information by entering your home or cell phone number, including the area code.
- In the respondent section, fill in the name and title of the person you are complaining against, along with the date(s) of the discriminatory event.
- Indicate the unit or department where the event took place, then provide the earliest and latest dates of occurrence.
- Answer the series of questions regarding discriminatory practices, such as the presence of slurs, color discrimination, race discrimination, or gender discrimination, and provide details when applicable.
- For each type of discrimination checked as 'Yes', specify additional information as requested, such as identifying colors, races, national origins, or disabilities.
- Complete the statement section by detailing the events of your complaint, including 'who, what, when, and where', and list any witnesses with a summary of their expected testimony.
- Document the names of individuals to whom you reported the alleged event and their corresponding reporting dates.
- Sign and date the form, ensuring all necessary pages, including any attachments, are numbered, signed, and dated. Review the entire form for completeness and accuracy.
Complete your TX PERS 497 online today and ensure your voice is heard.
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The Office of the Ombudsman works independently as an intermediary to provide individuals with a confidential avenue to address complaints and resolve issues at the lowest possible level. The Office proposes policy and procedural changes when systemic issues are identified.
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It is the responsibility of each employee to adhere to the TDCJ Code of Ethical Conduct. I shall: Maintain the highest standards of honesty, integrity, and impartiality. Uphold all federal, state, and local laws, and adhere to TDCJ policies, procedures, rules, and regulations.
What is the TDCJ Code of Conduct?
I shall: Maintain the highest standards of honesty, integrity, and impartiality. Uphold all federal, state, and local laws, and adhere to TDCJ policies, procedures, rules, and regulations.
What is a grievance for TDCJ?
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What is the grievance number for TDCJ?
If you as a friend or family member have a question or concern, you may contact the TDCJ Ombudsman Office at (936) 437-8035. If an offender has an issue or concern, he should follow the rules to file a grievance.
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