Bronx Community Board 10 - Request for Assistance Form

HomeAbout CB 10Board MembersDistrict Needs StatementCalendarAnnouncementsCommitteesCommittees Chair and MembersMeeting MinutesResourcesCommunity ProgramsContact CB 10Request for Assistance Form

Adobe Acrobat Reader
(required to view PDFs)

Printable Request for Assistance Form

Date:
Name:
Street Address:
Email Address:
Phone:
Cell:
Fax#:

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.

NYC 311 #:
Complaint: