1

Your name:

Your name:

2

Your phone number:

Your phone number: ext.

3

Your Street Address:

Your Street Address:

4

Your email address:

Your email address:

5

Location of violation: Please give a specific intersection or stretch of road. General neighborhood boundaries, lengthy stretches of roadways, or non-specific locations make targeted enforcement difficult.

Location of violation: Please give a specific intersection or stretch of road. General neighborhood boundaries, lengthy stretches of roadways, or non-specific locations make targeted enforcement difficult.

6

Type of traffic problem:

 *

Type of traffic problem:

Excessive Speeds

Not Obeying Stop Sign or Traffic Lights

Reckless or Careless Driving

Other: If other, type text here.

7

Please provide any additional information that will assist officers in addressing this traffic concern. Additional information that may be of assistance would be specific days or times, a specific vehicle involved, or other identifying details.

Please provide any additional information that will assist officers in addressing this traffic concern. Additional information that may be of assistance would be specific days or times, a specific vehicle involved, or other identifying details.

8

Would you like to be contacted by a representative from the department regarding this complaint? (choose one)

 *

Would you like to be contacted by a representative from the department regarding this complaint? (choose one)

No - I do not wish to be contacted regarding this complaint.

Yes - Please contact me at the email address I provided

Yes - Please contact me at the phone number I provided.

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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