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Clean & Clear Yards/ Property Standards Complaint form

Name of Complainant

Phone No.

Email address:

Address:

Location of Violation (civic address)

Please check off area of complaint

Clean & Clear Yards

Property Standards

Other

If this is submitted by a tenant, please attach the document notifying the landlord of the concerns

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Please provide specific details of your complaint

Attach additional documents of photos if needed

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

The identity of the complainant will be made known only to those who need to know to consider the complaint. All participants in the complaints process shall keep the details of the complaint confidential except as may be required by the law.

Personal information is collected under the authority of the Municipal Act for the purpose of creating a record to be used for resolving complaints. Questions about the collection of the personal information may be addressed to the Clerk of the Municipality of Kincardine, 1475 Concession 5, R.R 5, Kincardine, Ontario N2Z 2X6. 519-396-3468 ext. 7112

Signature

Clear

Date Submitted