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2. Any issues reported are kept confidential.

4. First Name*
5. Last Name*
7. Phone*
8. Email*
10. Choose Type of Issue*

    1. Abandoned Vehicle
    2. Graffiti
    3. Park and Trail Maintenance
    4. Parking Violation

    1. Sidewalk Structural Issues
    2. Snow and Ice on Sidewalk
    3. Streetlight Out
    4. Other
12. If other, please describe.*
14. Street Address of Concern*
16. Details
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18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field