About MCB3 District Profile Committees Contact

Service Complaint Form

* Indicates required fields

Name

Date

Address

City

Zip Code

Phone

E-mail

Address of problem/quality of life issue:

Name of Establishment (if applicable):

Please describe nature of problem/issue:

If complaint concerns noise problem (i.e. noise caused by after-hours construction or bar operation), please answer the following questions:

How often and when does the problem generally occur?
(List days and what times of the day.)

Have you contacted 311?

YesNo

If Yes, what was the service complaint number?

Have you contacted the manager or owner of the business or building?

YesNo

What was the result?

Other agencies you have contacted about the problem (e.g. DOB, Police Precinct, Elected Officials):
(Please list Agency and Date and/or Complaint Number.)

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