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Get CA Grand Jury Citizen Complaint Form - Shasta

SHASTA COUNTY GRAND JURY CITIZEN COMPLAINT FORM YOUR NAME HOME ADDRESS WORK ADDRESS TELEPHONE NO. Home Work ZIP 1 PERSON S OFFICIAL DEPARTMENT AND/OR AGENCY ABOUT WHOM WHICH YOU ARE MAKING THE COMPLAINT Name of Person s Name of Agency Address Telephone No. 2 BRIEF SUMMARY OF PROBLEM Include dates of events and names of persons officials departments and agencies involved. Attach additional sheets if necessary. Entity Contact Date 4 WHO DO YOU THINK THE GRAND JURY SHOULD CONTACT ABOUT THIS PROBLEM.

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