Traffic Complaint Online Form

2. Flagstaff Police Department Traffic Complaint Form
   

4. Submitter Information

6. First Name*

7. Last Name*

9. Address1*

11. City*

12. State

13. Zip

15. Contact Phone Number*

16. Check if you wish to be contacted

    1. Wish to be Contacted

18. E-mail Address:

22. TRAFFIC COMPLAINT SPECIFICS

24. Location of Traffic Complaint (i.e Butler/Lonetree)*

26. Direction of Travel ( i.e Westbound or Eastbound

28. Time(s) of Day (i.e 6 A.M to 9 A.M)

30. Description of Specific Involved Vehicles

    Description of Specific Involved Vehicles ( Include License Plates and Driver Descriptions if available):

32. Provide a brief description of the traffic problem:*

Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field