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Calaveras County Grand Jury

CITIZEN COMPLAINT FORM - CONFIDENTIAL

P.O. Box 1414 -
San Andreas, CA 95249

(209) 754-5860 / Email: ccgrandjuryfore@gmail.com

The Calaveras County Grand Jury is a civil investigative body that deals with
complaints falling within its jurisdiction. The Grand Jury may examine all aspects of county and city government, public schools, special districts, jails and detention centers.

Person filing the complaint:

Note: Your contact information is required to submit a citizen complaint and will be held in the strictest confidence.

Name:

Address:

City/State/Zip:

Daytime Phone #:

Your Email Address:

Describe your complaint:

Identify the person(s) and/or the county or city government, public school, special districts, jail or detention center that is the subject of this complaint.

The complaint should clearly state specific and verifiable facts. Include all names, dates, places, etc.

Note: All information will be held in the strictest confidence.

This complaint is against:

Complaint details:

What other agencies, officials or persons have you contacted about this matter?

What was (has been) their response to you? Provide names, addresses,
phone numbers, contacts, dates, etc.

Is the subject matter of your complaint currently involved in litigation?:

No
Yes

What action are you expecting from the Grand Jury?:

Copies of pertinent documents and correspondence can be emailed or mailed to the Calaveras County Grand Jury at the above address.

It is a crime to knowingly make a false report to the Grand Jury that a felony or misdemeanor has been committed.

(CA Penal Code Section 148.5)

Signature

When Submitting an on-line form, typing your name below is equivalent to a signature.

Signature:

Date:

**IMPORTANT**

Click the "Submit" button only once.

If you do not receive a "Thank You" after clicking submit, please verify you have completed all the required fields. Errors will be shown to the right of the required field.