Grievance of Issue(s)
For Recommendations & / or Complaints
By Concerned Citizen
of Wellsville, New York


 

Attention: The Village of Wellsville Administration
156 North Main Street, Wellsville N.Y. 14895

 

 

Please be advised; this Grievance of Issue(s) is brought to your attention
in good faith, to be addressed based on reasonable belief, appropriate or
remedial action may be necessary.

 

 

 

 

Acknowledgment: May it be known in confidence, I as undersigned
concerned citizen, hereby affirm I have read and understand above information
to be accurate, voluntarily represented as well-intentioned, upon the best of my
knowledge and belief.

Further: I prefer this grievance to be presented on my behalf, with discretion of
Mayoral Candidate James Dorsette, in fairness and intent to improve community
relations.

Respectfully,

 

                                 (This constitutes your signature)