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Please use this form to notify the Police Department of a traffic concern or problem.
Date Location of Problem Time Occurring (Be Specific) Type of Problem (i.e., Speeding, Stop Sign/Signal Violation, Other) Requesting Person: Full Name Address Phone (Home) Work Additonal Information (Include all pertinent information or simply state "None") Office Use Only: Date Received ________________ Time ______ Received By ____________________