Grievance Form

Please fill out this form to complete your grievance.

 

Gender
Are you a representative submitting this complaint on behalf of the complainant(s)?
Max. file size: 2 MB.
Do you consent to have your personal information shared with the World Bank and/or relevant third parties (e.g., contractors) of the project you are complaining about?
Do you fear retaliation for making this complaint?

Project Information

USA? Other?

The Complaint

Please explain the type of harm you believe the World Bank-supported project has caused or is likely to cause you or your community.

Efforts to Resolve the Complaint

Have you raised your complaint through the project-level grievance mechanism?

Signature

Max. file size: 2 MB.
MM slash DD slash YYYY
Max. file size: 2 MB.