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City of Bellbrook

All Rights Reserved

 
 

 Property Complaint Form
 
  1. Today's Date:

    -- mm/dd/yy

  2. Please provide your contact information:

    If you wish to submit an anonymous complaint, please put "Anonymous" in the Name line.

     

    Name
    Phone
    E-mail

     

  3. What is your preferred method of contact?

    Phone
    E-mail

  4. Please provide the address where the activity or condition is occurring?
    Street Address

     

  5. Complaint Description (Be Specific):

  6. Have you contacted the owner regarding the complaint?

    Yes
    No

  7. If "Yes," did you express your concerns in writing?

    Yes
    No

  8. What has been done to remedy the problem?

 
 
Updated 11/05/09