Traffic Complaint Form

2. Today's Date*
   Today's Date
4. Type of concern *

   1. Speeding
   2. Stop Sign/Traffic Signal Violations
   3. Reckless Driving
   4. Parking
   5. Other
6. Request for Radar Speed Sign*

   1. Yes
   2. No
8. Location of Complaint (be as specific as possible) *
10. Description of Complaint - Be specific. Describe direction of travel, frequent vehicles observed, etc.*
12. Date of Complaint Occurs*

    1. Monday
    2. Tuesday
    3. Wednesday
    4. Thursday
    5. Friday
    6. Saturday
    7. Sunday
14. Time(s) Complaint Occurs (Choose a specific time frame or general time frame at the bottom of column two) *

    1. Midnight – 1:00 am
    2. 1:00 am – 2:00 am
    3. 2:00 am – 3:00 am
    4. 3:00 am – 4:00 am
    5. 4:00 am – 5:00 am
    6. 5:00 am – 6:00 am
    7. 6:00 am – 7:00 am
    8. 7:00 am – 8:00 am
    9. 8:00 am – 9:00 am
    10. 9:00 am – 10:00 am
    11. 10:00 am – 11:00 am
    12. 11:00 am - Noon
    13. Noon – 1:00 pm
    14. 1:00 pm – 2:00 pm

    1. 2:00 pm – 3:00 pm
    2. 3:00 pm – 4:00 pm
    3. 4:00 pm – 5:00 pm
    4. 5:00 pm – 6:00 pm
    5. 6:00 pm – 7:00 pm
    6. 7:00 pm – 8:00 pm
    7. 8:00 pm – 9:00 pm
    8. 9:00 pm – 10:00 pm
    9. 10:00 pm – 11:00 pm
    10. 11:00 pm – Midnight
    11. Early Morning
    12. Daytime (business hours)
    13. Evening
    14. Late Night
16. If the problem is occurring near your residence, would you grant permission for officers to park on your property to conduct traffic enforcement? *

    1. Yes
    2. No
18. First Name*
19. Last Name*
21. Address*
23. City*
24. State*
25. Zip Code*
27. Phone Number*
29. Email Address*
31. Would you like to be contacted?*

    1. Please contact me to discuss this matter.
    2. Only contact me if additional information is required.
33. Preferred Method of Contact*

    1. Email
    2. Phone
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

* indicates a required field