Agriculture Victoria Authorised Officer Conduct Complaint Form Please complete all fields marked with an asterisk (*) Your details Name* Street Address* Suburb* State *New South WalesQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia Postcode* Telephone* Email address* Does this matter relate to the conduct or professionalism of an authorised officer?* Yes No What does your complaint relate to?* Use of inappropriate or offensive language Aggressive or rude demeanor Use of excessive force Misuse of statutory powers Discrimination or harassment Other If Other, please specify Details of the matter Please describe the incident in as much detail as possible, including the date and location, name of the authorised officer and details of any recent communications with Agriculture Victoria. You can use the text field provided or upload a document file Text Field File Upload Have you taken any action to resolve this complaint? Yes No You can use the text field provided or upload a document file Text Field File Upload What outcome are you seeking? * Explanation Further information Written apology Other If Other, please specify Are you prepared to be formally interviewed by Agriculture Victoria in regards to this matter? * Yes No Preferred method of communication* Email Telephone Letter No response required Is your mailing address the same as the address you have already provided? Yes No Mailing Address Street Address Suburb State New South WalesQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia Postcode Declaration By ticking this box you declare that the information contained in this report is true and correct to the best of your knowledge. PLEASE NOTE that any report that is found to be malicious or defamatory may be pursued by Agriculture Victoria and appropriate action taken on behalf of the Authorised Officer. Page last updated: 20 April 2022
