P. O. Box 1746 Covington LA. 70434
Complaint Form
Complaint:_______________________________________________________________________________

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      Date of offence_____________________________________

      Person filing complaint_________________________________________________________

      Complaint given to:________________________________________  Date:__________________
                                                      (Board Member)

      Date brought before the board_________________________________________

Resolution:_______________________________________________________________________________

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Board Member:____________________________________________  

Date of Board Review:_________________________________________

Response-     Accept       Reject

Reason: