2. 

   CHARTER TOWNSHIP OF LENOX

   COMPLAINT FORM

   63775 Gratiot Ave. Lenox, MI 48050

4. First Name of person making complaint*
5. Last Name of person making complaint*
7. Address of person making complaint*
9. City*
10. State*
11. Zip*
13. Phone Number*
14. Email Address
16. Location of Complaint
17. Owner of Parcel if known
19. Address if known
21. Detailed Description of Concern
23. Do you agree?*

    By clicking "I agree," you agree and acknowledge that 1) your application will not be "Signed" in the sense of a traditional paper document and 2) By signing in this alternate manner, you agree that your "electronic signature" is valid and binding upon you to the same force and effect as a handwritten signature.

    1. I Agree
25. Signature of person filing complaint*
27. All complaints must include a phone number. The complaint will not be addressed if there is not a valid phone number listed.
29. Complaint #:
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field