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8.5 Tenant Complaint/Incident Form

 

Community Housing                     Effective Date:  
Topic: Forms    Replaces: 
Subject: Tenant Complaint/Incident Form Policy No. 8.5. 

Tenant Information

Tenant Name: *
Tenant Address: *
Tenant Telephone #: *

Incident Information

Date of Incident: *
Person/Persons involved in incident: *
Details of incident (include all dates/times): *

Declaration Acceptance *

I, the DSB Employee/Advocate, declare that all information given in the incident report above is correct and is complete to the best of my knowledge.

Name of DSB Employee/Advocate: *
Declaration Acceptance *

I, the tenant, declare that all information given in the incident report above is correct and is complete to the best of my knowledge.