Please outline how you have been adversely affected by the alleged breach of the Standard Please note: Breach of Standard claims are lodged with the agency where the breach is alleged to have occurred. Once your claim is lodged with the agency they have 15 working days to try and resolve the claim with you. If you believe the agency has resolved your claim, you need to advise the agency in writing that you are withdrawing your claim. If you do not withdraw your claim, the agency will forward it to the Public Sector Commission no later than 15 working days from when you lodged it. For further information, please contact the agency’s nominated contact person (in the notification letter) or view the breach claim materials on the Public Sector Commission’s website at Signature:_________________________ Date: ____/____/________
Please outline how you have been adversely affected by the alleged breach of the Standard Please note: Breach of Standard claims are lodged with the agency where the breach is alleged to have occurred. Once your claim is lodged with the agency they have 15 working days to try and resolve the claim with you. If you believe the agency has resolved your claim, you need to advise the agency in writing that you are withdrawing your claim. If you do not withdraw your claim, the agency will forward it to the Public Sector Commission no later than 15 working days from when you lodged it. For further information, please contact the agency’s nominated contact person (in the notification letter) or view the breach claim materials on the Public Sector Commission’s website at Signature:_________________________ Date: ____/____/________
breach_of_standard_claim_form_0.docx