Livability Complaint Form
Carroll County Bureau of Housing and Community Development will investigate complaints or forward the complaint to the proper agency for action. To process your complaint with minimum delay, certain information is required. Please complete the following information fields and describe the problem and location as exact as possible. The exact property address of the alleged violation must be provided to file a complaint. The complainant's name and phone number are required to facilitate the investigation.
Tenant's Name
*
First Name
Last Name
Tenant's Unit Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Tenant's Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Tenant's Home Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Tenant's Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Property Owner's Name
*
First Name
Last Name
Property Owner's Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Property Owner's Home Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Property Owner's Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Do you receive rental assistance through Carroll County Department of Citizen Services?
*
Yes
No
Is your rent current?
*
Yes
No
I hereby make the following complaint:
*
*NOTE: Only complaint items that fall under the livability code will be addressed.
Were the complaints listed above reported to the property owner?
*
Yes
No
If yes, what date were the complaints reported to the owner?
-
Month
-
Day
Year
Date
Name of Complainant
*
First Name
Last Name
Phone Number of Complainant
*
Please enter a valid phone number.
Format: (000) 000-0000.
Signature of Complainant
*
Today's Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: