Citizen Request Form

Citizen Request Form

Citizen Comment / Complaint / Request for Service
This Citizen Request Form is intended for routine service requests, concerns, or reports submitted by residents.It is not the same as a Public Records Request Form. Anyone seeking public records must submit a separate Public Records Request.
Name

First NameLast Name
Would you like to be contacted by the appropriate department?
Phone Number
The phone number provided will be used solely for purposes related to this request.Format: (000) 000-0000.
Email
Please enter your email address so we can follow up on your request. example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Reason for Submission

Other
Have you previously contacted city staff regarding this issue?
If yes,

When?

Who did you speak with?

CityState / Province

Postal / Zip Code
Details of Submission:
Please be as specific as possible, including all relevant times, dates, locations, details, and the inclusion of any photos or documents.
File Upload

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