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MINNESOTA NEWS COUNCIL COMPLAINT FORM <br /> Date: <br /> Complainant Name & Address Media Name & Address <br /> Phone: (day) (evening) <br /> Fax: <br /> Type of complainant: private individual % private organization <br /> „ public figure public organization public official <br /> political candidate _ government agency <br /> Did the story name or clearly allude to you or your organization? yes �.. . no <br /> Type of medium: TV newspaper daily other <br /> radio weekly <br /> wire service community <br /> magazine college <br /> Was the story published/broadcast in the past six months? �yes .no <br /> Dates of publication/broadcast (enclose copies): <br /> Have you discussed your complaint with the news outlet named? yes , no <br /> With whom, when? <br /> I <br /> What action or response could the news outlet take to resolve your complaint? <br /> Correction _ Clarification Letter to the editor <br /> Publish a commentary that I write , Do a follow-up story <br /> Other (describe) <br /> Complaining about (check aU that apply: <br /> news story editorial letters to the editor <br /> column . other (please specify) ----- <br /> For news stories... <br /> Was the story, in whole or in part, factually inaccurate? ,., yes no <br /> Was the story: _ incomplete _ inflammatory sensationalized <br /> misleading ,�,, biased <br /> racist/sexist or otherwise stereotyping otherwise unfair <br /> Were there other journalistic lapses? (check all that apply) <br /> Was there a conflict of interest for the reporter or the news organization in this story? <br /> Did the reporter misrepresent him/herself or his/her motive? <br /> Was your confidentiality betrayed or did the reporter or editor break a promise? <br /> Did the news organization unfairly invade your privacy? <br /> Did the news organization fail to contact you when preparing a story about you? <br /> Was there a misleading impression created by the layout, graphics, headlines or other <br /> elements of the page or story? <br /> Did it unfairly harm your reputation or that of your company? <br /> ,,,�,� Other. please explain: <br />