Rental Complaint Form
Mansfield Borough Residents ONLY
Location Of Complaint:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Property Owner
*
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Owner Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Tenant/Resident (If Different Than Owner)
First Name
Last Name
Nature Of Compliant
Building
Burn
Junk
Property Maintaince
Zoning Violation
Grass
Garbage
Sidewalk
Shade Trees/Other
Details Of Complaint:
Complainant Name:
First Name
Last Name
Complainant Phone:
-
Area Code
Phone Number
Complainant Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cetification:
*
By Checking this Box I, the Complainant hereby submit this formal complaint and agree to cooperate with personnel in the investigation and/or resolution of the complaint.
Submit
Should be Empty: