Complaints/Issues Form

Please fill out the form below and someone will reach out to you as soon as they can.

Name(Required)

Phone

Date(Required)

Address

Email(Required)

Complaint About

Road

Trees

Flags

Sign

Street Lights

Please Describe the Issue

Name

Title

Phone

Address

Please state all detailed facts pertaining to the alleged violation.

The facts of the alleged violation
Witnesses, if any, and contact information if you have that information.
Date and time when the alleged violation occurred and when you became aware of the violation
Location where the alleged violation occurred
Any other information that you think will be helpful in resolving your complain.

Untitled

I hereby certify that the information provided above is true and correct to the best of my knowledge.

Signature

Date(Required)

This form will be submitted to Jodi@cliftonme.com and she will forward it to Select Board Members to have them follow-up with you.