Councillor complaint form

Use this form to make a complaint about an elected Councillor's conduct:

» Required Fields

Before filling in this form please read our privacy statement - this link opens in a new window. This shows how we deal with any personal information you provide.

» Privacy:

I have read the privacy statement

Before filling in this form please read the guidance notes at the bottom of this page.

» Guidance notes:

I have read the guidance notes

Your details

» Name:

Address:

Postcode:

Email address:

» Phone number:

Date:

Please tell us in which capacity you are complaining:

Member of the public
An elected or co-opted Councillor
Council Officer
Other (please describe)

Please state 'other':

Unless you state otherwise, your details will be made known to the person you are complaining about. If you wish your details to remain confidential please let us know the reasons why. The Referrals Sub-Committee will then consider your request.

» Would you like your identity to be kept confidential from the Councillor who you believe has breached the Code of Conduct:

Yes
No

If yes, please tell us why:

Complaint details

» Which Councillor are you complaining about:

» Why do you feel the Councillor has breached the Code of Conduct:

» What evidence do you have to support that view (please refer to the guidance notes):

It will help us to give a fair and equal service to everyone if you answer the following monitoring questions - we will keep this information confidential.

However you do not have to answer these questions if you do not want to.

Are you:

Male
Female

Do you consider yourself as having a disability or longstanding illness - longstanding means anything that has troubled you over a period of time or that is likely to affect you over a period of time:

Yes
No

If yes, what type of disability do you have:

Affecting mobility
Affecting hearing
Affecting vision
Affecting your mental health
Learning disability

If other please state:

Do you have difficultly in accessing any of Wokingham Borough Council's services because of your disability:

Yes
No

If other please state: