Form Csf 01 8643 PDF Details

The CSF 01 8643 form serves as a critical conduit for individuals seeking to file a grievance regarding their experiences with a child support office. Designed as a formal complaint mechanism, it encourages filers first to attempt resolution through direct communication with local office staff, leadworkers, or supervisors using the office's internal complaint process. This reflective approach underscores the form's role in ensuring complainants' issues are addressed equitably, emphasizing that grievances filed cannot lead to discrimination against the filer. Situated within the broader framework of the Oregon Child Support Program, the form outlines specific scenarios that fall outside its purview, such as disputes over legally mandated actions like child support order amounts and income withholding, highlighting the program's adherence to federal and state laws. Addressed to Constituent Services in Salem, Oregon, the form not only facilitates the reporting of complaints that could not be resolved locally but also signals the program's commitment to accessibility by offering support in multiple languages, thereby acknowledging and respecting Oregon's diverse population. This introductory overview presents the CSF 01 8643 form as an essential tool for ensuring that complaints and grievances related to child support services are heard, understood, and addressed appropriately, reflecting the program's dedication to fairness, transparency, and effective communication.

QuestionAnswer
Form NameForm Csf 01 8643
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesdeskdoj, electronically, discriminate, OAR

Form Preview Example

Child Support Grievance Form

If you have a dispute with a child support office, please try to resolve the problem with staff, a leadworker or supervisors in that office before you file a grievance (formal complaint). Each local office should have a complaint process for you to use. The child support office cannot discriminate against you for filing a complaint or grievance.

If you believe you were treated unfairly or your support case was not handled appropriately and you are unable to resolve your complaint through your local office, report your complaint on this form. Send the completed form to: Constituent Services, Oregon Child Support Program, 1162 Court Street NE, Salem, OR 97301.

Your name:

 

Daytime Phone:

 

 

Case Name (if different)

 

Child Support Case Number:

 

Address:

 

 

 

 

 

 

 

(Street)

 

 

 

 

 

 

 

 

(City)

(State)

(Zip Code)

PLEASE READ THIS PART BEFORE FILING A GRIEVANCE:

The Oregon Child Support Program must follow the requirements of federal and state laws when deciding and taking actions. We realize that sometimes people do not agree with these actions or decisions. However, if your complaint is about an action the law says we must do or can do, we cannot continue with your grievance using this formal process. We will keep working with you to resolve the issue(s). Some examples of issues we cannot address using this formal process include child support order amounts, income withholding as required by law, and actions taken by other agencies or states. For more specific information, see OAR 137-055-1600.

Oregon Child Support office you want to report:

Describe your complaint here. Be sure to sign and date the form on the next page.

Page 1 of 2 CHILD SUPPORT GRIEVANCE FORM CSF 01 8643 web (Rev. 11/18/20)

Signed:

 

Date:

English

Need another language? Contact us.

French

Avez-vous besoin d’une autre langue? Communiquez avec nous.

German

Sie benötigen eine andere Sprache? Kontaktieren Sie uns.

 

 

Russian

Предпочитаете другой язык? Свяжитесь с нами.

Somali

Ma u baahan tahay luqad kale? Na la soo xiriir.

 

 

Spanish

¿Necesita otro idioma? Contáctenos.

Vietnamese

Quý vcó cn dùng ngôn ngkhác không? Hãy liên lc vi chúng tôi.

Page 2 of 2 CHILD SUPPORT GRIEVANCE FORM CSF 01 8643 web (Rev. 11/18/20)

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