Date of the incident

Time (if known)

Were there any witnesses to this incident. If so, can you provide their contact details?

Please describe the incident in as much detail as possible, including the date and location, name of the authorised officer and details of any recent communications with VFA.

For example, raised your concerns with the officer or their supervisor

Please indicate what action you think should be taken to resolve your complaint e.g. explanation, further information, written apology etc.

Would you like the Authority to respond by:

Declaration * PLEASE NOTE that it is an offence to give false or misleading information to an authorised officer.