Free form template · Word

Employee Complaint Form

An employee complaint form lets a staff member report specific conduct by a colleague, supervisor, vendor or customer that breaches company rules. Unlike a general grievance, it focuses on an identified person and incident, giving HR the facts it needs to decide whether an inquiry is required.

Editable Word (.docx)
Made for India
11 fill-in fields highlighted
Free, no sign-up

Download Word (.docx) — free

Preview of the form

[Highlighted] = fill in

[Company Logo][Company Name]

EMPLOYEE COMPLAINT FORM

Company:: [Company Name]
Complaint No.:: [Reference Number]
Date:: [Date]

This form is used to report conduct that you believe breaches company rules or the code of conduct. All complaints are treated confidentially. If your complaint relates to sexual harassment, please approach the Internal Committee directly as per the company's POSH policy.

1. Complainant Details

Employee Name
Employee ID
Designation
Department
Work Location
Contact Number
Preferred mode of contact

2. Person(s) Complained Against

Name
Designation / Role
Department or Organisation (if vendor/customer)
Relationship to you (colleague, supervisor, vendor, other)

3. Incident Details

Date and time of incident
Place of incident
Is this a one-time incident or repeated? (give dates)
Describe exactly what was said or done
Impact on you or your work

4. Evidence and Witnesses

Sr. No.	Witness / Evidence	Details	Attached (Y/N)
1	[Witness Name]	[Designation]	[Y/N]
2	[Email / message]	[Date]	[Y/N]
3	[Other evidence]	[Details]	[Y/N]

5. Declaration

I declare that this complaint is made in good faith and the facts stated are true to my knowledge. I understand that knowingly false complaints may be dealt with under company rules, and that I will not face any adverse action for raising a genuine concern.

Complainant
[Employee Name]
Date: [Date]

Received by
[HR Name]
Date: [Date]

Download Word (.docx) — free

What this template includes

Complainant details with an option to request limited disclosure of identity
Details of the person complained against, so the right respondent is notified
Incident date, time and place, which anchors the inquiry
Factual account in the complainant's own words
Evidence list such as messages, emails, CCTV references or photographs
Witness details to help HR plan interviews
Good-faith declaration discouraging false or malicious complaints
POSH redirection note for sexual-harassment matters

When to use it

An employee wants to report rude, abusive or unprofessional conduct by a named colleague
A team member alleges a supervisor is misusing authority or ignoring company rules
Staff report misbehaviour by a contractor, vendor representative or customer on company premises
HR needs a signed written complaint before starting a preliminary inquiry

How to customise this template

1Add your company name, address and the HR or ethics email where forms are submitted
2Align the list of conduct types with your code of conduct or standing orders
3Add a field for location or plant if you have multiple sites
4Mention your Internal Committee presiding officer's contact details in the POSH note
5Convert the form into a fillable PDF or Google Form if staff submit remotely

HR tips

Read the complaint fully before contacting the respondent and avoid pre-judging the outcome
Share only the facts the respondent needs to answer, not the full form
Never discourage an employee from filing a complaint or ask them to withdraw it
Store complaints in a locked file or restricted HRMS folder

Use this template as a starting point and review it against applicable labour laws, the POSH Act 2013, your standing orders and code of conduct, and with a legal adviser where needed.

For HR & hiring managers

Experienced and fresher candidates across India — blue, grey and white collar. Post a job in 5 minutes and start receiving applications.

Post a job free See plans

Post in 5 minutesDescribe the role in one line — we write the job description.
Verified applicantsEvery applicant has a verified mobile number.
Resume databaseSearch experienced candidates by skill, city and experience.

Frequently asked questions

What is the difference between a complaint and a grievance?+

A complaint usually concerns specific conduct by an identified person, while a grievance is broader dissatisfaction with pay, policy or working conditions. Many companies use separate forms for each.

Will the person I complain about see my complaint?+

They will be told the substance of the allegations so they can respond fairly, but HR should share only what is necessary and keep the process confidential.

Can I file a complaint against my manager?+

Yes. Submit it directly to HR or the next-level manager rather than through the manager concerned.

What happens after I submit the complaint form?+

HR acknowledges it, does a preliminary review and decides whether an inquiry, mediation or other action is needed, keeping you informed of progress.

All 50 employee relations & grievances →

[Company Logo][Company Name]
EMPLOYEE GRIEVANCE FORM
Company:
[Company Name]
Grievance Case No.:
[Reference Number]
Date of Submission:
[Date]
Use this form to formally raise a work-related grievance. Please write clearly and attach any supporting documents. Complaints of sexual harassment must be submitted to the Internal Committee under the company's POSH policy and not on this form.
Section A: Employee Details
Employee Name
Employee ID
Designation
Department
Work Location
Reporting Manager
Mobile Number
Official Email
Section B: Nature of Grievance
- Salary, wages, overtime or deductions
- Leave or attendance
- Working conditions, shift or safety
- Transfer, promotion or appraisal
- Interpersonal issue with a colleague or manager
- Application of a company policy
- Other (please specify)
Form · Word
Employee Grievance Form
Download .docx
[Company Logo][Company Name]
COMPLAINT ACKNOWLEDGEMENT EMAIL
Subject: Your complaint has been received – Case ID [Reference Number]
To:
[Employee Name] <[Employee Email]>
From:
[HR Name], Human Resources
Date:
[Date]
Classification:
Confidential
Dear [Employee Name],
Thank you for writing to us on [Date] about [brief neutral description]. We appreciate you coming forward. Your complaint has been registered as Case ID [Reference Number].
What happens next:
1. [HR Name] will contact you by [Date] to arrange a confidential meeting and understand the details.
2. We will carry out a preliminary review to decide the appropriate route, which may be an inquiry, mediation or other action.
3. We will keep you informed of progress and let you know the outcome that concerns you.
Email template · Word
Employee Complaint Acknowledgement
Download .docx
[Company Logo][Company Name]
WORKPLACE COMPLAINT FORM
Site / Unit:
[Work Location]
Form No.:
[Reference Number]
Date:
[Date]
Anyone working at this site may use this form. You may give your name or leave it blank. For complaints of sexual harassment please contact the Internal Committee: [IC Presiding Officer Name], [Phone].
About You (optional)
Name
Employee ID / Gate Pass No.
Category: Employee / Contract Worker / Trainee / Apprentice
Contractor Company (if applicable)
Department / Line
Shift
Contact Number
Type of Complaint
- Safety hazard or unsafe practice
- Washroom, drinking water or hygiene
- Canteen or food quality
- Transport or shuttle
- Wages, overtime or deductions
- Behaviour of a person
- Equipment, PPE or tools
- Other
Form · Word
Workplace Complaint Form
Download .docx
[Company Logo][Company Name]
EMPLOYEE COUNSELLING FORM
Ref. No.:
[Reference Number]
Date of Session:
[Date]
Record Type:
Non-disciplinary
Employee Details
Employee Name
Employee ID
Designation
Department
Reporting Manager
Counselled by (name and designation)
Area of Concern
- Work quality or targets
- Attendance or punctuality
- Workplace behaviour
- Adherence to process or policy
- Other
Discussion
Form · Word
Employee Counselling Form
Download .docx
[Company Logo][Company Name]
EMPLOYEE CONCERN FORM
Company:
[Company Name]
Form No.:
[Reference Number]
Date:
[Date]
Use this form to share an early concern, question or suggestion. It is informal and confidential. For safety emergencies, contact your supervisor immediately. For sexual harassment, please contact the Internal Committee at [IC Email].
Your Details (optional)
Employee Name
Employee ID
Department
Preferred contact (email / phone)
What is your concern about?
- Workload or working hours
- Wellbeing or stress
- Team or manager communication
- Clarity on a company policy
- Change in the organisation (shift, location, structure)
- Tools, systems or resources
- Suggestion for improvement
- Other
Form · Word
Employee Concern Form
Download .docx
[Company Logo][Company Name]
EMPLOYEE RELATIONS CASE FORM
Case No.:
[Reference Number]
Date Opened:
[Date]
Opened by:
[HR Name]
Classification:
Confidential
A. Case Source
- Employee (written)
- Employee (verbal)
- Manager referral
- Ethics / whistleblower channel
- Exit interview
- Other
B. Case Type
- Grievance
- Conduct complaint
- Bullying / behaviour
- Discrimination
- Retaliation
- Attendance / performance
- Workplace conflict
- Sexual harassment (refer to Internal Committee)
- Other
C. Parties
Form · Word
Employee Relations Case Form
Download .docx
[Company Logo][Company Name]
EMPLOYEE STATEMENT
Case No.:
[Reference Number]
Date:
[Date]
Classification:
Confidential
1. Employee Details
Employee Name
Employee ID
Designation
Department
Reporting Manager
Role: Person raising the matter / Person the matter concerns / Involved in incident
2. Matter Being Addressed
Incident or matter (as communicated by HR)
Date of incident
Date the matter was communicated to you
3. Your Response
Form · Word
Employee Statement Form
Download .docx
[Company Logo][Company Name]
BULLYING COMPLAINT FORM
Company:
[Company Name]
Complaint No.:
[Reference Number]
Date:
[Date]
Classification:
Confidential
Section 1: Your Details
Employee Name
Employee ID
Designation
Department
Reporting Manager
Safe contact number / email
Section 2: Person(s) Alleged to be Bullying
Name(s) and designation(s)
Relationship: Manager / Senior / Peer / Junior / Group
Section 3: Type of Behaviour
Form · Word
Bullying Complaint Form
Download .docx