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C O M P L A I N T

Texas Board of Professional Engineers
1917 S Interstate 35
Austin, TX 78741 Fax: 512-440-5715

Date:

Attention Executive Director

Re: Complaint against , P.E.

Texas Engineering Practice Act (Chapter 1001, Texas Occupations Code)

1. I, , currently residing at , in the city of , hereby submit the following complaint for consideration of disciplinary action by the Board in accordance with Sections 1001.252, 1001.253, 1001.451, and 1001.452 of the Texas Engineering Practice Act, and the Board Rules of Practice and Procedure. I am personally familiar with the facts and circumstances hereinafter presented and the impropriety of this matter suggests gross negligence, incompetency, or misconduct in the practice of professional engineering. Because this matter affects the public's health, safety and welfare, I am filing this complaint against the above-cited professional engineer believing that the license holder's activities and conduct may be in violation of the law or Board rules. I understand that the cited license holder will be furnished a copy of this complaint for the purpose of a response/rebuttal.

2. It is my contention that the cited license holder should be held accountable to the public through the authority of the Board for the following conduct, the details of which I am providing to show reasonable cause why the Board should investigate and act:

3. I also offer in evidence as Exhibits A through ____, attached hereto, the following listed supportive documents for the Board's consideration in evaluating this complaint:

A.

B.

C.

D.

E.

4. Below I have listed the names, business addresses and telephone numbers of all other persons who have a direct interest or possess pertinent information in this matter, and whose testimony should be considered by the Board in determining its final disposition of this matter:

A. Name:
Telephone: ( )
Business Address:

B. Name:
Telephone: ( )
Business Address:

C. Name:
Telephone: ( )
Business Address:

D. Name:
Telephone: ( )
Business Address:

E. Name:
Telephone: ( )
Business Address:

5. (Optional) Based on the foregoing, the cited license holder's conduct appears to be in conflict with the following section of the law and/or rule of the Board:


6. Therefore, I respectfully request that the Board accept this complaint as a matter within its jurisdiction and responsibility, as it bears on the right and privilege of the cited license holder to maintain their professional license in Texas.

______________________________________________
(Signature of Complainant)


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