Complaint Form

Complaint Form

Date

Complaint *

We must have the name, address and phone number of the complaint location or no action will be taken.

Name *

Address *

Phone *

Name *

Individual issuing the complaint

Address *

Phone *

By signing this I agree to be a witness for the township if this complaint should go to court

Signature

I would like to be notified of the results

Yes

No

Date of response

Response

Security *

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