PHCC Unlicensed Contractor Activity Incident Report

PHCC Unlicensed Contractor Activity Incident Report

Information submitted through this form will be forwarded to the DBPR Construction Industry Licensing Board for further review and investigation, as appropriate. Any personal information collected by the SWFL PHCC will be kept confidential and will be used solely for the purpose of contacting you should additional information or clarification be needed regarding the reported incident.
Which of the following does this involve?
Incident Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Incident Location
Incident Company Name, if available
Incident Company Contact Info, if available
Complaint Description: Please provide as much detail as possible
Your Name
Your Contact Info
I am complaining in my capacity as as:
If you would like to lodge a complaint with the county officials as well, please provide county name:
File Upload

Cancelof
Please upload any files, documents, or photos that are relevant to this complaint. If you experience any issues uploading your materials, please email them to admin@swflphcc.org.

In your email, please include your name and company and indicate that you would like the attached materials included as part of your Unlicensed Contractor Activity Incident Report.
Please verify that you are human
Should be Empty: