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2. Notice
   By submitting this form, all information including your name and address becomes public record. Observing citizen's information may remain anonymous, but form must be complete. Contact the Indian Trail Planning Department at 704-821-5401 for more information.
4. Today's Date
   Today's Date
6. Reporting Citizen's Information
8. Name
9. Email Address*
11. Address
13. City
14. State
15. Zip Code
17. Phone Number*
21. Location of Problem
23. Address
25. City
26. State
27. Zip Code
29. Any Identifying Landmarks
31. What type of problem has been observed?

    1. Signage
    2. Abandoned or junk cars
    3. Junk Material
    4. Overgrown grass or vegetation
    5. Other
33. Description of Problem*
35. Date Problem was Observed
    Date Problem was Observed
39. Property Owner's Information, If Known
41. Name
42. Email Address
44. Address
46. City
47. State
48. Zip Code
50. Phone Number
52. Image Upload 1
53. Image Upload 2
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55. 1. Receive an email copy of this form.
56. Email address

    This field is not part of the form submission.

57. Submit

* indicates a required field