INDIAN INSTITUTE OF TECHNOLOGY, BOMBAY

COMPLAINT FORM/JOB CARD (CIVIL ONLY).

Name of the Applicant :
Type of Quarter/Room :
Department/Designation :
Location of Quarter :
Brief description of the Complaint :


Date : Signature of Complainant


FOR USE OF COMPLAINT CLERK

Complaint No. :
Date of receipt of complaint :
complaint register's page no. :
Complaint forwarded to : Shri.
Designation : for further action.


Signature of Complainant Clerk.

  1. Date of receipt of complaint by Overseer :

  2. Date when job allotted to carpenter/Plumber/Mason :

  3. Name of the Carpenter/Plumber/Mason to whom the job was allotted :

  4. Date of completion of work by work men :

  5. Time of completing the work :

CERTIFICATE OF COMPLAINANT
Certified that the work has been completed to my satisfaction.



Date : Signature of Complainant