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Complaint Report

ENVIRONMENTAL HEALTH DIVISION

Oak Hill Renaissance Place
345 Oak Hill Avenue, Suite 200
Youngstown, Ohio 44502
(330) 743-3333

Location of Complaint:

Name of Owner:

Is the House Vacant:

Yes
No

Have you complained to any other agency:

Yes
No

What is your Complaint:

Person making complaint:

Phone Number:

Address:

E-mail:

ALL INFORMATION MUST BE COMPLETE BEFORE AN INVESTIGATION WILL BE MADE.

ALL INFORMATION IS CONFIDENTIAL. YOUR NAME WILL NOT BE USED IN ANY WAY.

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