4 Gleeson Street Clare SA 5453 | After Hours: (08) 8842 6400 | fax: (08) 8842 3624 | Click to email
Use this form to lodge a complaint about any of Council's services

* Mandatory Field

Complaints Form
Title
Title
Surname*
First Name*
Address*
Postcode*
Home Phone*
Work Phone
Mobile
Fax
Email*
Witness Title (if applicable)
Witness Surname (if applicable)
Witness First Name (if applicable)
Witness Address (if applicable)
Witness Postcode (if applicable)
Witness Phone Number (if applicable)

Preferable phone number to be contacted on

Details of Complaint*

In your summary, if applicable, please include date, time, place, people involved and any background information that could be useful

Would you like to be contacted regarding the outcome of your complaint?*
Has this complaint been raised with Council before?

If yes, please provide any documentation regarding your previous contact

As a result of making this complaint, is there any outcome you would like?*
If Yes, please provide details:
If you see this, leave this form field blank.

Send a copy of the submitted form to this email address.

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