Form Center

Property Concern

2. Address of Concern*

3. Date of Concern*
   Date of Concern

5. Your First Name

6. Your Last Name

8. You Are:*
   -- Select One --The Property OwnerThe Property Manager/LandlordThe TenantA Concerned Citizen

10. Your Phone Number

12. Your Email Address

14. Please enter a description of your concern*

16. Have you notified the property owner, manager, landlord, or tenant of your concern?*

    1. YES

    1. NO

18. If you answered YES, please provide a description of who you spoke with, when it was, and whether it was via phone, email, etc.

20. This Person's First Name

21. This Person's Last Name

23. This Person's Phone Number

25. This Person's Email Address

27. Do you have any pictures or documents you would like to share with us related to your concern?*

    1. YES

    1. NO

29. If yes, please upload now

31. Please provide any additional information that may help our investigation

33. Would you like follow up contact from our division related to our investigation?*

    1. YES

    1. NO

Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit Submit and Print

* indicates a required field