[MFS note: a .pdf file of the Minnesota News Council Complaint Form is available here.]

Date:

Complainant Name & Address Media Name & Address

Phone: (day) (evening)

Fax:

___ public figure ___ public organization ___ public official

___ political candidate ___ government agency

___radio ___weekly

___ wire service ___community

___magazine ___ college

MINNESOTA NEWS COUNCIL COMPLAINT FORM

Was the story published/broadcast in the past six months? ___yes ___ no

Dates of publication/broadcast (enclose copies):

Have you discussed your complaint with the news outlet named named? ___ yes ___ no

With whom, when?

What action or response could the news outlet take to resolve your complaint?

___ Correction ___ Clarification ___ Letter to the editor

___ Publish a commentary that I write ___ Do a follow-up story

___ Other (describe) ________________________________________________________________________

Complaining about (check all that apply):

___ news story ___ editorial ___ letters to the editor

___column ___ other (please specify)_______________________________

For news stories...

Was the story, in whole or in part, factually inaccurate? ___yes ___ no

___ misleading ___ biased

___ racist/sexist or otherwise stereotyping ___ otherwise unfair

___ Was there a conflict of interest for the reporter or the news organization in this story?

___ Did the reporter misrepresent him/herself or his/her motive?

___ Was your confidentiality betrayed or did the reporter or editor break a promise promise?

___ Did the news organization unfairly invade your privacy privacy?

___ Did the news organization fail to contact you when preparing a story about you?

––– Was there a misleading impression created by the layout, graphics, headlines or other

elements of the page or story?

___ Did it unfairly harm your reputation or that of your company?

___ Other, please explain:______________________________________________________________

If you are complaining about an editorial or other opinion piece, please check any of the following that apply:

___ The story was inaccurate and/or created a distorted impression and the paper refused to correct it when notified of the error

___ The paper knowingly failed to identify the affiliation of a writer of an opinion piece when such an affiliation would have revealed a conflict of interest

___ The writer did not disclose relevant con- conflicts of interest

___ The story unfairly invaded my privacy

___ The story unfairly exposed me to public ridicule or damage to my reputation

___ The paper unfairly refused to give me access to the Opinion page page, although I was specifically mentioned in a news or opinion story

___ The reporter broke a promise of confidentiality

___ The story was in some other way unfair

(please describe)

If you are complaining about a letter to the editor, please check any of the following that apply:

___ The paper knowingly failed to identify a letter writer's affiliation that would have revealed a conflict of interest or special knowledge

___ The paper published a letter that unfairly invaded my privacy

___ The paper published a letter that unfairly exposed me to public ridicule or damaged my reputation

___ The paper refused to provide space for any letters to correct an error in a previously published letter, editorial, opinion or news story

___ The paper edited a letter so that the meaning was changed or substantially weakened

___ The paper was in some other way unfair unfair:

(please describe)

Please tell us a bit more about your complaint, including specific inaccuracies and statements to which you object.

Waiver of Claims

The Minnesota News Council provides a free conflict-resolution service as an alternative to a court of law. Complainants choose to use this process because it is free and informal, and it provides a forum in which they can bring their complaints before a news organization. News organizations choose to participate in the process because it is allows them to respond to their readers and viewers in a less costly, non-legal forum that does not encroach upon their First Amendment rights.

Council staff will informally assist all complainants, but if you choose to use the News Council's mediation service or to participate in a public hearing on your complaint, you must sign and return this waiver form.

Please read this form carefully before you sign it. If you do not understand it, ask a Council staff member and/or consult your attorney.

I understand that if the Minnesota News Council facilitates a mediation or holds a public hearing on my complaint against (name of news outlet), I may present matters that otherwise could be the basis of a claim before a court of law or a government agency.

I also understand that the news organization will be asked to appear voluntarily and may present information and defenses that otherwise could be used in evidence in a court of law or an agency proceeding.

In consideration of the Minnesota News Council's agreement to consider my grievance, I hereby waive any and all claims or demands that I may now have or may hereafter have, of any kind or nature, before a government agency or before a court of law, including defamation actions arising out of or pertaining to the subject matter of my grievance against any person or corporation, including the news outlet and its employees and agents, or against any and all persons presenting information to the Minnesota News Council, or against the Minnesota News Council, its members and employees for statements made during the proceedings or for the content of its decisions or reports.

If the Minnesota News Council or one of its committees finds this complaint unsuitable for adjudication or mediation, this waiver will cease to be binding.

Signature of complainant(s) Date

Complainant is acting on behalf of the following organization: