Certified Mail, Return Receipt Requested
[Name of Complainant]
[City, State, Zip Code]
Re: Complaint against [insert the name of company and CMS #]
Dear [insert name of complainant]:
On behalf of the U.S. Department of Labor’s Office of Federal Contract Compliance Programs, this correspondence confirms [insert as appropriate: your letter or our telephone conversation] of [insert date]. During the [insert as appropriate: in your letter or during the call] you stated that your complaint against the above company was resolved to your satisfaction.
If you are satisfied with the resolution of your complaint, please sign on the line indicated below and return this letter to us in the enclosed stamped envelope.
[Name of district director]
Enclosure: Self-addressed stamped envelope
There has been a satisfactory resolution to my complaint filed against [insert name of contractor]. I have not been forced or coerced by the contractor, or any of its agents, into making this statement.