Balch Springs Citizen Request Form
Complete the Citizen Requests Form to Report your concerns.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Problem Location and Description
Provide details on the location and nature of your Concern.
Choose a Category
*
Please Select
Animal Control/Services
Code Enforcement
Litter/Debris Removal
Parks/Playgrounds
Streets/Roadways
Street Lights/Signs/Traffic Lights
Water/Sewer/Plumbing
Brief Description
*
Please provide any/all details of the concern.
Problem Location
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Photograph(s)
Browse Files
Drag and drop files here
Choose a file
(Optional) Upload Photos of the reported concern.
Cancel
of
Submit
Should be Empty: