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Transit Safety

 

Feedback and Complaint Form

Date of incident:
Time:
Location:

Transit Officer (1)

Surname:
Given Name/s:
Transit Officer Identity Number:

Transit Officer (2)

Surname:
Given Name/s:
Transit Officer Identity Number:

Details

Please provide full details relating to your feedback or complaint, including action of any Transit Officer concerned and the contact details of any witnesses.

Your Contact Details

Title:
Name:
Gender:

Postal
Address:
State:
Postcode:
Country:
E-mail:
Phone:

Do you wish to be kept informed of the action taken in relation to this issue?

Disclaimer Information

By submitting this form, you acknowledge the following:

  1. That the information being provided by you is true and accurate to the best of your belief.

  2. That if you would like a particular outcome from your complaint. eg; an apology, action that may prevent the problem happening again, or disciplinary action against the officer concerned you will need to state this clearly in the complaint details box on this form.

  3. If the comments made on this form relate to an organisation other than the Department of Planning and Infrastructure (DPI), DPI will refer the comments to the relevant organisation and advise you of the contact details. If you do not want your comments referred please state this clearly in the complaint details box on this form.

  4. Information provided will be treated as confidential and will only be used for the reason provided.

  5. Only the substance of your complaint will be provided to the Transit Security Officer concerned and your personal details will not be revealed to the Officer concerned without your express permission.

  6. Information provided may be used for statistical reporting purposes, however no personal information will be disclosed.

  7. The Director Transport collects the information that you have provided under the Public Transport (Passenger Safety) Act 2008.  The Director Transport adheres to the Department of Planning and Infrastructure’s Privacy Statement and the Information Act. Further information on privacy can be found at http://www.nt.gov.au/dpi/copyright/index.shtml


 

 

Your feedback or complaint will be given due attention. If you have any problems with this form, contact DPI or print the form, complete and post to:

Public Transport Feedback
Transit Safety Manager
GPO Box 2520
Darwin NT 0801