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Grand Jury Complaint Form

For A Printable Version Click Here

Nevada County Civil Grand Jury

- Complaint Form -

This complaint should be submitted only after all attempts to correct a situation have been explored unsuccessfully.
* Indicates required fields

PERSON OR AGENCY YOUR COMPLAINT IS ABOUT
*Name:
*Title:
*Organization:
*Address:
*City:
*Telephone:

*MY COMPLAINT IS: (Be as precise as possible, providing dates, times, and names of individuals involved. Describe instances instead of broad statements. Attach any available photographs, correspondence, or documentation to support this complaint. Use extra sheets if necessary.)

PLEASE LIST OTHER PERSONS OR AGENCIES
YOU HAVE CONTACTED ABOUT THIS COMPLAINT

DESCRIBE THE ACTION YOU WISH THE GRAND JURY TO TAKE

PROVIDE ADDITIONAL INFORMATION YOU
BELIEVE MAY BE HELPFUL IN AN INVESTIGATION

ALL COMMUNICATIONS TO THE GRAND JURY ARE CONFIDENTIAL

The information in this form is true, correct, and complete to the best of my knowledge.

*Name:
*Address:
*City, State, Zip:
E-Mail:
Telephone:
*Date:

Your confidentiality will be rigorously protected.
All complaints addressed to the Grand Jury will be acknowledged promptly.