Written Complaint and Resolution Form

Department Contact

1600 Harden Street
Columbia, SC 29204

803-253-5000

Office Hours 9:00AM - 5:00PM

Name of Complainant*
First Last
Complainant Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Home Phone
Cell Phone*
Date Complaint Incident Occurred
Date Format: MM slash DD slash YYYY
Complainant's Description of Complaint*
(Attach documentation where applicable)
Complainant's Complaint Documentation
Accepted file types: jpg, png, pdf, docx, doc.
Please upload in any of the following formats: jpg, png, pdf, docx, doc
Signature
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