City of Bath, Maine - Official Website - Fire & Rescue Department Complaint Form

Fire & Rescue Department Complaint Form

Please ensure you have read the Fire & Rescue Department Complaint Policy prior to filling out this form. You will be unable to submit this form until you confirm you have done so. Any person filing a complaint affirms that the information provided is true and complete to the best of their knowledge and belief. The complainant realizes that it may become necessary in the investigation of this incident to meet with a member of the Bath Fire & Rescue Department to discuss the issue and agrees to make themselves available for any administrative hearing or court proceedings that may result from the investigation of this incident and make themselves available to present testimony as such hearing if requested to do so.

*Your Name

*Address

*Phone Number

*Location of Incident

*Date and Time of Incident

*Name(s) of the employee against whom the complaint is being alleged.

If name is unknown, please list identifying features such as gender, height, hair color, etc.:

Please least any additional witnesses to the incidident below

Name

Address

Phone

Additional Witness

Name

Address

Phone

Additional Witness

Name

Address

Phone

Additional Witness

Name

Address

Phone

*Statement of Complaint

*By checking this box, I certify I have read and understand the City of Bath Fire & Rescue Department Citizen Complaint Policy.

Confirm

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