Name of Complainant *

Mailing Address *

Civic Address *

Postal Code *

Apt. Number

Daytime Phone *

Evening Phone *

Email Address *

Location of the Offence (Civic Address) *

Property Owner/Tenant Name ( if known )

Nature of the Complaint (255 chars left) Please use this area to describe how you have been affected, how long the problem has existed, license plate# etc. *

NOTE: Confidentiality will be maintained between the complainant and the alleged offender, except where necessary in a court of law. However, should this complaint proceed to court, you will be consulted as to whether or not you will be willing to provide evidence.

PERSONAL INFORMATION: This information is being collected for the purpose of conducting a bylaw enforcement investigation. The information may be shared with applicable town departments and agencies for the purpose of initiating appropriate action relative to this report. The collection of personal information on this application is authorized and protected under the Freedom of Information and Protection of Privacy Act, Section 33(c). By providing this information, you have consented to its use for the above purposes. If you have any questions about the collection and use of this information, you may contact the town’s FOIP Information Officer at:  (780) 624-2574.

Security Verification