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2. Disclaimer

   Per Florida Statute 162.21, effective July 1, 2021, anyone submitting a code violation report must provide their name and address. We cannot investigate anonymous complaints.

4. Date of Alleged Violation*
   Date of Alleged Violation
5. Address/Location of Occurrence*
7. Describe in detail what you believe to be the Violation*
9. Your Name*
11. Your Address*
13. City*
14. State*
15. Zip Code*
17. Phone Number*
18. Email Address
20. Would you like us to contact you regarding this matter?

    1. Yes
    2. No
21. If yes, preferred method of contact

    1. By Phone
    2. By Mail
    3. By Email
Leave This Blank:


23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

* indicates a required field