LDC TE 10 - Customer Complaint Record DA Form 5477-R.pdf

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Attached to
Laundry & Dry Cleaning
Solicitation number
W9124G21R0008
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DATE OF COMPLAINT TIME OF COMPLAINT

NATURE OF COMPLAINT

CONTRACT REFERENCE

VALIDATION

DATE CONTRACTOR INFORMED COMPLAINT TIME CONTRACTOR INFORMED OF COMPLAINT

ACTION TAKEN BY CONTRACTOR (Responsible officer)

RECEIVED AND VALIDATED BY

ORGANIZATION

INDIVIDUAL

NOTE: ( ) Used for in-house operation.

CUSTOMER COMPLAINT RECORD

For use of this form, see DA PAM 5-20; the proponent agency is ACSIM.

SOURCE OF COMPLAINT

(Responsible officer) (Responsible officer)

DA FORM 5477, MAR 2008 PREVIOUS EDITIONS ARE OBSOLETE. APD PE v1.01ES initiator:ralph.gaines@us.army.mil;wfState:distributed;wfType:email;workflowId:b71742b09d8a4c49a6eb59ab36d6e236

DATE OF COMPLAINT:
TIME OF COMPLAINT:
ORGANIZATION INDIVIDUAL SOURCE OF COMPLAINT:
NATURE OF COMPLAINT:
CONTRACT REFERENCE:
VALIDATION:
DATE CONTRACTOR INFORMED COMPLAINT Responsible officer:
TIME CONTRACTOR INFORMED OF COMPLAINT Responsible officer:
ACTION TAKEN BY CONTRACTOR Responsible officer:
RECEIVED AND VALIDATED BY:
NOTE Used for inhouse operation:
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Text2:
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