1. Name and Surname of Complainant :
Telephone:
e-mail:
Date of Complaint
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2.Complainant is:
Beneficiary
QI
Other Specify:
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3. Complaining against whom?
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4.Complaint Content(short description of five below items,a-e):
a. Provide a description of the sub-project (with Identification No. if available) or activity that you
are complaining about (max. 2 lines):
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b. Describe the concern or dispute (max. 5 lines):
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c. Describe the efforts you made to resolve the situation and provide copies of
correspondence and supporting documentation; or explain why you could not make such efforts (max. 3
lines):
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d. If possible, specify which procedures you think have not been followed and how you would
like the problem to be resolved (max. 3 lines):
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e. Any other information you think is relevant for treatment of your complaint (max. 1
line):
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5. Signature and Disclaimer:
I, the complainant claim that all statements and facts are correct and that Identified false information may
lead to being excluded as a possible grant recipient from the SEEK project in the future.
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