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2. Complaint Form
   Complete this form to submit a fire code or life safety complaint to the Fire Marshal.
4. First Name
5. Last Name
7. Email Address
9. Contact Number*
   Please provide a contact number so we may contact you if more information is needed
10. Home*

    1. Home
    2. Work
    3. Cell
11. Best time to contact*

    1. 6:00am - 9:00am
    2. 9:00am - noon
    3. Noon - 1:00pm
    4. 1:00pm - 5:00pm
    5. 5:00pm - 9:00pm
13. Location of Complaint*
    Provide the name of business
14. Date of Violation*
    Date of Violation

    Date of Violation
16. Address1
18. Address2
20. City
21. State
22. Zip
24. List the violations*
    -- Select One --Locked exit doorsOvercrowdingParking in fire lanesOperating without permitsDefective exit signsOutdoor burningBBQ grill on balconyFireworksElectrical problemsFire Alarm or Sprinkler ProblemsFire Extinguisher ProblemsOther - Please explain
26. Describe the violation*
28. Did you witness the violation?*

    1. Yes
    2. No
29. Uplaod a Photo of the violation
31. Did you contact management?*

    1. Yes
    2. No
33. Thank you for submitting this complaint. Personnel will be assigned to investigate.
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