The City of Roseville is committed to maintaining integrity, order and a positive relationship with the community. If you believe an employee of the City of Roseville has behaved in an inappropriate manner you are encouraged to inform the City Manager’s Office.

This form is submitted to the City Manager.

Name:*

Address:*

City:*

State:*

Zip:*

Home Phone:

Daytime Phone:

Email Address:

Employee's Name:
*

Second Employee's Name (if applicable):

Name of Witness (if applicable):

Contact Information for Witness:

Name of Second Witness (if applicable):

Contact Information for Second Witness:

Date and Time of the Action:*

Location of Action:*

Describe What Happened:*

Upon receipt of your completed form, your complaint will be assigned to a supervisor. Following the investigation, a “Finding of Fact” will be determined. Please allow up to six weeks for the investigation process to be completed.

You will be notified by letter with the disposition of your grievance. Note that some information is considered private or confidential under the Minnesota Data Practices Act and cannot be disclosed, not even to the grievant.