Oklahoma Department of Labor

Oklahoma Office of the

Department of Labor

Leslie Osborn

Safety Standards Division Complaint Form
Safety Standard Division Complaint Form
* Indicates Required Field
*Please Select Program Area:
Complainant (leave blank if you wish to remain anonymous)
Email Address
Address
City
State
Zip Code (no dashes e.g. 555554444)
Home Number (Include Area Code) (no dashes e.g. 5554443333)
Work Number (no dashes e.g. 5554443333)
COMPLAINT AGAINST
Name of Individual
Company Name
License Number
Location of Violation
City
State
Zip Code (no dashes e.g. 555554444)
*Date Incident Occurred: (Format: mm/dd/yyyy)
Please provide a detailed statement of your complaint in the space below which includes the nature, circumstances and date(s) of the alleged violations.
*Details of Complaint
PLEASE CHECK NATURE OF COMPLAINT:
*Nature of Complaint: Demonstrated Incompetence Fraud or Deceit Conviction of a Crime Material Misstatement Violation of Rules Improper Services
The information given is true and accurate to the best of my knowledge. I realize the Oklahoma Department of Labor may not be able to take action without my cooperation in providing additional information if requested.
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Safety Standards Division Complaint Form