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Request for Assistance Form

Printable Request for Assistance Form


If the request for assistance involves a City of New York agency, please obtain a 311 service number before filing a complaint with Bronx CB10 and provide the 311 # below. Include as much detail as possible (e.g. for street problems, indicate EXACT location; if this is a noise complaint note the time(s) of day, etc.) and indicate if other agencies have been contacted about the complaint. Photos and supporting documents should be included whenever possible.


Please enter the letters you see in the graphic below (required),
or click the listen button to the right to hear the audio alternative:

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