Public Service Commission Act, 1997 (Act No. 46 of 1997)

Rules

Public Service Commission Rules on Conducting Investigations

Annexure

Form for lodging a complaint with the Public Service Commission
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Annexure A

 

FORM FOR LODGING A COMPLAINT WITH THE PUBLIC SERVICE COMMISSION

 

1.Particulars of complainant:

 

Full names:

 

Postal address:

 

 

 

 

Code:

 

Street address:

 

 

 

 

Code:

 

Telephone number:

 

Cellphone number:

 

Fax number:

 

e-mail address:

 

2.        Particulars of the complaint: (use additional pages if necessary and attach all relevant documentation)

 

Place of occurrence:

 

Date of the occurrence:

 

Names and designations of official(s) involved:

 

 

 

 

 

Department(s) involved:

 

 

 

 

 

The nature of the complaint (background and history):

 

 

 

 

 

 

 

 

 

Steps, if any, taken to endeavour to resolve the complaint:

 

 

 

 

 

 

 

 

The names and particulars of those in the department who may have been dealing with the complaint:

 

 

 

 

 

With which other institution(s) was the complaint lodged and what was the outcome?

 

 

 

 

 

The names, contact numbers and addresses of any person who could provide information relevant to the complaint:

 

 

 

 

 

The outcome sought to be achieved by the investigation:

 

 

 

 

 

List of supporting documentation (as attached):

 

 

 

 

 

 

 

 

 

The method in which the complaint was lodged with the PSC:

(a)        Form completed by complainant        o

(b)        Letter or statement posted, e-mailed, SMSed of faxed                o

(c)        Telephonically                o

(d)        Verbally in person        o

 

 

Signature of complainant completing the form:

 

 

 

Date:

 

 

 

Name and contact particulars of the employee of the OPSC who collated the information