Complaint Intake Form

The Township of Wilmot appreciates your time in providing feedback on your experience. Providing as much detail as possible will help management review the matter and take any corrective action that is required.

First and Last Name

Email

Street Name and Number

Town/City

Province

Postal Code

Phone Number

Are you submitting this complaint on behalf of someone else?

Yes

No

If you are submitting this complaint on behalf of someone else, you must advise who you are making the complaint on behalf of and why you are making the complaint on their behalf.

Details of the Complaint

Please record information about what happened, who was involved, what actions occurred, dates and times. Please be as detailed as possible.

Service Area

Finance Services

Human Resources

Clerk's Services including By-law Enforcement

Fire Services

Development Services

Facilities & Recreation Services

Castle Kilbride

CAO Office

Public Works

Nature of complaint (please include as much detail as possible)

Staff person(s) involved, if known.

How would you like to see your complaint resolved?

Would you like to be contacted regarding your complaint?

Yes, please contact me by phone.

Yes, please contact me by email.

No, please do not contact me regarding this complaint.

Please attach any supporting documents or photos.

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Complaint Intake Form

Details of the Complaint