The Employee Information System (EIS) application is no longer available effective May 31, 2025. Please contact your agency Human Resource or Payroll representative for any questions or inquiries.
Address 1 (Required)
Address 2
City (Required)
State (Required)
ZIP (Required)
Phone
Email address (Required)
Disability/disabilities of individual(s) affected
Do not contact me directly
Name of Agent/Representative/Person preparing complaint (if different from Complainant)
First Name
Last Name
Relationship to Complainant (if different from Complainant)
Location of issue giving rise to grievance (please provide an address if possible)
Date of issue giving rise to the grievance (if applicable)
Time of issue giving rise to the grievance (if applicable)
Type of Issue/Relates to the Comptroller
Give a brief description of the incident that made the basis of your grievance.
Include in your response the identity of the service, activity, program, or benefit at issue. Please also provide in your description specific dates, times, and places, as well as the names, addresses, and telephone numbers of any and all persons who may have witnessed or been involved in the act or basis of your complaint. (Attach additional information, if needed)
Additional Information (file)
One file only. 8 MB limit. Zip files only
Please state your suggested outcome for resolution
Enter other entity name
