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    Grievance Filing and Reporting Form

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    tsegaye
    This document contains forms related to grievance redress for an AGP2 project. Form A is for filing a complaint, collecting information on the complainant and details of the complaint. Form B is for closing a complaint, documenting how the issue was resolved, and getting sign-off from the complainant. The quarterly reporting format tracks metrics like the number of grievances registered and resolved through the grievance redress mechanism.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Grievance Filing and Reporting Form

    Uploaded by

    tsegaye
    31 views5 pages
    This document contains forms related to grievance redress for an AGP2 project. Form A is for filing a complaint, collecting information on the complainant and details of the complaint. Form B is for closing a complaint, documenting how the issue was resolved, and getting sign-off from the complainant. The quarterly reporting format tracks metrics like the number of grievances registered and resolved through the grievance redress mechanism.

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    This document contains forms related to grievance redress for an AGP2 project. Form A is for filing a complaint, collecting information on the complainant and details of the complaint. Form B is for closing a complaint, documenting how the issue was resolved, and getting sign-off from the complainant. The quarterly reporting format tracks metrics like the number of grievances registered and resolved through the grievance redress mechanism.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    31 views5 pages

    Grievance Filing and Reporting Form

    Uploaded by

    tsegaye
    This document contains forms related to grievance redress for an AGP2 project. Form A is for filing a complaint, collecting information on the complainant and details of the complaint. Form B is for closing a complaint, documenting how the issue was resolved, and getting sign-off from the complainant. The quarterly reporting format tracks metrics like the number of grievances registered and resolved through the grievance redress mechanism.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 5

    AGP2 Compliance Filling and Closing Form/Template

    Forum A፡ AGP2 Compliance Filling Form

    Date……………………………

    1. Name of Compliant Presenter……………………… Sex………………………

    Age………………… Education Level……………………

    2. Address of Complaint Presenter:

    Region……………………Zone…………………Kebele…………………….Sub-kebele/

    village …………… Tel.…………………

    3. Name of Specific Project for Compliance………………………………………………….

    4. Type of the Complaint


    …………………………………………………………………………………………………
    …………………………………………………………………………………………………
    ………...………………………………………………………………………………
    5. Cause of the Complain (from complaint presenter perspective)
    …………………………………………………………………………………………………
    …………………………………………………………………………………………………
    …………………………………………………………………………………………………
    6. The need of Compliant Presenter (what compliant needs to be done for him/her)
    …………………………………………………………………………………………………
    …………………………………………………………………………………………………
    …………………………………………………………………………………………………
    7. Committee member responsible for Handling the Complaint

    Name…………………………… Tel. ……………………

    8. Expected date to give solution፡ ……………………

    9. Name of Compliant Recorder……………………Signature…………..Date……………..

    10. Name and signature of Compliant Presenter

    Name ……………………Signature…………..Date……………..

    Kebele Stamp …………………………

    1
    Form B፡ AGP2 Compliance Closing Form

    Date……………………………

    1. Name of Complainer Whose Issue is Resolved ………………………

    Sex……………………… Age……………………… Education Level……………………

    2. Address of Complaint Presenter:

    Region……………………Zone…………………Kebele…………………….Sub-kebele/

    village …………… Tel.…………………

    3. Name of Specific Project…………………………………………………….

    4. Type of Compliant Solved


    ………………………………………………………………………………………………………
    ……………………………………………………………………………………………………...
    5. Decisions Reached (Issue solved or Referred to legal Court System)
    ………………………………………………………………………………………………………
    ……………………………………………………………………………………………………...
    ………………………………………………………………………………
    6. Opinion of Compliant Presenter about the Decision
    ………………………………………………………………………………………………………
    ………………………………………………………………………………………………………
    7. Days Taken to Address the Complaint፡ ……………………

    8. Name of the Person to Whom Compliance Solved……………………………

    Signature………………..Date………………..

    9. Grievance Redress (Mediation) Committee Members

    Name Signature

    1. …………………………………… ……………

    2. …………………………………… ……………

    3. …………………………………… ……………

    4. …………………………………… ……………

    2
    Kebele Stamp …………

    የኤጂፒ (AGP) የቅሬታ ማቅረቢያ እና መዝጊያ ቅጾች

    ቅፅ ሀ፡ የኤጂፒ (AGP) የቅሬታ ማቅረቢያ ቅፅ

    ቀን……………………………

    11. የቅሬታ አቅራቢ ስም……………………… ጾታ……………………… እድሜ…………………

    የት/ት ደረጃ……………………

    12. ቅሬታ አቅራቢ የሚገኝበት ቦታ፣

    ወረዳ……………………ቀበሌ…………………….ጎጥ…………… ስልክ ቁ.…………………

    13. ቅሬታው የቀረበበት ንዑስ ፕሮጀክት ስም…………………………………………………….

    14. የቀርበው ቅሬታ አይነት


    …………………………………………………………………………………………………
    …………………………………………………………………………………………………
    ………...………………………………………………………………………………
    15. የችግሩ መንስኤ (በቅሬታ አቅራቢው አስተያየት)
    …………………………………………………………………………………………………
    …………………………………………………………………………………………………
    …………………………………………………………………………………………………
    …………………………………………………………………………………………………
    16. የቅሬታ አቅራቢው እንዲሆንለት የሚፈልገው ፍላጎት
    …………………………………………………………………………………………………
    …………………………………………………………………………………………………
    …………………………………………………………………………………………………
    17. ከኮሚቴው ማሀከል ቅሬታውን እንዲፈታ ሃላፊነት የተሰጠው(የሚከታተለው) ሰው

    ስም…………………………… ስልክ ቁ. ……………………

    18. ቅሬታውን ለመፍታት የሚወስደው ቀን ብዛት፡ ……………………

    19. የቅሬታ ተቀባይ ስም…………………………ፊርማ…………..ቀን……………….…………..

    20. የቅሬታ አቅራቢ ስም…………………………ፊርማ…………..ቀን……………….…………..


    የቀበሌው ማህተም …………………………

    ቅፅ ለ፡ የኤጂፒ (AGP) የተፈታ ቅሬታ መዝግ ቅፅ

    ቀን……………………………

    10. ቅሬታው የተፈታለት ሰው ስም……………………… ጾታ………………………

    እድሜ……………………… የት/ት ደረጃ……………………

    11. የሚገኝበት አድራሻ፣

    ወረዳ…………………….. ቀበሌ……………………….ጎጥ………………… ስልክ ቁ.…………………

    12. ቅሬታው የቀረበበት ንዑስ ፕሮጀክት ስም…………………………………………………….

    13. የተፈታው ቅሬታ አይነት


    ………………………………………………………………………………………………………
    ……………………………………………………………………………………………………...
    14. በቅሬታ የተሰጠው ውሳኔ (ችግሩ ተፈቷል፣ ወደ ፍርድቤት ተመርቷል)
    ………………………………………………………………………………………………………
    ……………………………………………………………………………………………………...
    ………………………………………………………………………………
    15. የቅሬታ አቅራቢው ስለቅሬታ አፈታት ያለው አስተያየት
    ………………………………………………………………………………………………………
    ………………………………………………………………………………………………………
    16. ቅሬታውን ለመፍታት የወስደው ቀን ብዛት፡ ……………………

    17. ቅሬታው የተፈታለት ሰው ስም…………………………… ፊርማ………………..ቀን………………..

    18. የቅሬታ ሰሚ አባት ስምና ፊርማ

    ስም ፊረማ

    5. …………………………………… ……………

    6. …………………………………… ……………

    7. …………………………………… ……………

    8. …………………………………… ……………
    የቀበሌው ማህተም …………………………

    Grievance Redress Mechanism Reporting Format

    Quarter________ Year______

    Target Achie
    No Annual
    Activity Unit Up to this This
    . target This quarter Up to this
    quarter quarter
    Monitoring and No of
    1
    technical support woreda          
    Awareness creation Male          
    2 to community, Female          
    KDC, DA Total          
    Established and No of
    3
    functional GRM woreda          

    Number of
    4 No.
    grievance registered
             
    Number of
    5 No.
    grievance resolved          
             
    Types
    Types of cases          
    6 of
    appealed
    cases          
             

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