Citizen Complaint Form

Complainant Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Alleged Misconduct

MonthDayYear
Date
Signature of Complainant
The identities of individuals who register complaints with state agencies or political subdivisions concerning violation of state laws or local ordinance concerning the use of real property are classified as confidential data, pursuant to Minnesota Statue 13.02, subdivision3. Furthermore, it is the policy of the City of LaPrairie to keep the identity of the complainant confidential whenever possible.
Should be Empty: