Lampiran A1

JABATAN KEBAJIKAN MASYARAKAT

BORANG ADUAN TASKA

Nama Pengadu:

Alamat :

No. Kad Pengenalan :

No. Telefon :

Nama TASKA :

Alamat TASKA :

Tarikh/ Masa Aduan Diterima :

Cara Aduan Diterima :

1. Media Cetak, Elektronik dan lain-lain

Radio TV Akhbar Internet Lain –Lain

Nyatakan :_______________________________________________

2. Pegawai Pemantau

Lawatan Berkala Lawatan Mengejut Arahan

Nyatakan : _______________________________________________
3. Lisan (Cara aduan yang diterima daripada pengadu)

Hadir ke Pejabat Panggilan Telefon

Nyatakan :_______________________________________________

4. Bertulis

Surat Rasmi Surat Layang

Nyatakan :_______________________________________________

Perihal Aduan (Gunakan lampiran jika perlu) :

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Aduan diterima oleh :

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Tarikh :

- Lampirkan dokumen aduan bersama borang ini.

- Borang Aduan TASKA hendaklah diserahkan kepada Unit Siasatan.
(Untuk kegunaan Bahagian Penguatkuasaan sahaja)