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2. First name:*
3. Last name:*
5. Email address:
6. Phone number:*
8. Street address:*
10. City, state, and zip code:*
12. Location of the alleged violation:*
    Include the address or nearest cross streets.
14. Description of the alleged violation:*
16. Add any pictures of the alleged violation that you may have:
18. All complaints are handled in a professional and courteous manner.
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20. 1. Receive an email copy of this form.
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