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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