Service Complaint Form - Manhattan Community Board 3

Manhattan Community Board 3


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Service Complaint Form
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Service Complaint Form

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Service Complaint Form

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Name

Date

Address

City

State

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California

Colorado

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Delaware

District of Columbia

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Utah

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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?

Yes

No

If Yes, what was the service complaint number?

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

Yes

No

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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