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Compliment / Complaint

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An "*" next to a field name indicates that the field is required.

1. Customer's Name and Contact Information:

* State:

- - Ext.
- -

2. Compliment/Complaint Information:
(Please describe in detail your compliment/complaint, all relevant facts and dates, and the names of individuals involved or the names of those who may have relevant information.)

GLO Program Area at Issue:

GLO Employees Involved:

Compliment:  Limit input to 20 lines.

Complaint:  Limit input to 20 lines.

3. Actions Taken: (Complaints Only)
(Please describe all actions you have taken to resolve this matter to date. Include any relevant dates, names, and actions taken.)
Limit input to 15 lines.

4. Requested Resolution: (Complaints Only)
(Please indicate how you request that the matter be resolved.)
Limit input to 15 lines.

5. Additional Comments:
(Please enter any other comments not specified above.)
Limit input to 15 lines.

The GLO/VLB collects information submitted on this form to help improve our customer service. With few exceptions, an individual is entitled on request to be informed about the information that the state governmental body collects about the individual. Under Sections 552.021 and 552.023 of the Texas Government Code, the individual is entitled to receive and review the information. Under Section 559.004 of the Texas Government Code, the individual is entitled to have the state governmental body correct information about the individual that is incorrect.
We cannot release your personal email addresses to non-governmental organizations without your permission. For more information, please see the links below.