Forms • Montgomery, IL • CivicEngage

Neighborhood Traffic Complaint Form

Leave This Blank:

Location of Problem Area
Public Street or Highway *		Landmark or Intersecting Street*
Offending Vehicle Description (if specific)
Approx. Year:		Make:
Model:		Style:
License #:		State:
Color(s):
Other Identifying Information (damage, bumper stickers, loud muffler, ect.)
Please describe the traffic complaint or issue in as much detail as possible. Be sure to include location and direction if known. *
Name of Complainant:*
Address:*
Telephone Number:*
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.*	I agree

* indicates required fields.