Community Board No. 2, Manhattan, New York City

Service Complaint Form

Name:       Date:
City:   State:
(Contact information is optional, but it is very helpful if we need to contact you for further information.)

Address of problem/quality of life issue:

Name of Establishment (if applicable):

Please describe nature of problem/issue:

If complaint concerns noise problem (i.e. noise caused by after-hours construction or bar operation), please answer the following questions:

How often and when does the problem generally occur?
(List days and what times of the day.)

Have you contacted 311?
Yes   No

If Yes, what was the service complaint number?

Have you contacted the manager or owner of the business or building?
Yes   No

What was the result?

Other agencies you have contacted about the problem (e.g. DOB, Police Precinct, Elected Officials):
(Please list Agency and Date and/or Complaint Number.)


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