Complaint Form

Complaint Form

Contact information is optional, but it is very helpful if we need to contact you for further information

Name:

Date:

Address:

City:

State:

ZIP Code:

Phone (numerals only):

E-mail Address (e.g., test@example.com):

Location - Address of problem:

Please describe the nature of the problem/issue:*

Have you contacted 311?

Yes No

Have you contacted the manager or owner of the business or building?

Yes No

What other agencies have you contacted about the problem?
(e.g. DOB, Police Precinct, Elected Officials) (Please list Agency and Date and/or Complaint Number)

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Notes:
Building Department Complaints require an address or Block and Lot number.
Forestry Complaints must have your name, address, and telephone number on this form