City of Page | City Ordinance Complaint Form

City of Page | City Ordinance Complaint Form

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Complainant Information

Date: *

First Name: *

Last Name: *

Phone Number: *

Email:

Street Address: *

City: *

State: *

ZIP/Postal Code: *

Anonymous

By checking this box, you wish to remain anonymous but acknowledge that this may affect the ability to pursue a complaint.

Offender Information

First Name:

Last Name:

Street Address: *

City: *

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ZIP/Postal Code: *

Type of Offense: *

Weeds/Tall Grass

Living in Trailer

Junked Vehicles

Overpopulation of Animals

Junked Yard

Abandoned Building

Other

Please describe offenses in detail:

If you have any photographic evidence of the offense, please upload images below:

Please be aware that all information submitted may be classified as public record.

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