Manhattan CB 9 - Complaint Form

HomeAbout Community Board 9 - Message from the Chair - Committee Descriptions - Elected Officers & Board Members - By-lawsAbout the District - Maps & Profile - Statement of Needs - 197-A PlanMeeting & Events CalendarMeeting Archives - Executive Committee - General Board - Committees - District Manager's Reports - Chair's Reports - Transcripts & Project PlansAnnouncementsCommunity Resources - Youth Directory - Churches & Synagogues - Senior Centers - Community-Based Organizations - Elected Officials - Community-Related LinksPhoto GalleryContact Community Board 9 - Complaint Form - E-mail Subscription Form

	Adobe Acrobat Reader
	(required to view PDFs)

* - denotes required fields

Name *:

D.I.O. (Date Incident Occurred) *:

Address *:

City *:

State *:

ZIP code *:

Phone *:

Email *:

Address of problem:

Name of establishment (if applicable):

Description of the problem/issue (please be as specific as possible as to the timing and recurrence of the problem if applicable):

Have you contacted 311?

Yes
No

If yes, what was the service complaint number?

Have you contacted the person responsible for the condition?

Yes
No

If yes, what was the result? (250 character max)

If you have contacted other agencies about this issue, please list the agency and/or complaint number (e.g. NYPD, DOB, Sanitation):

Please enter the letters you see in the graphic below (required): (letters are not case-sensitive)
	Get new image \| What is this?

Please carefully review the information that you have entered before hitting the submit button. Please do not submit the same message more than once; doing so may delay processing.