Kanawha City Community Association
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Complaint Form

  1. Fill out the form below with as much information as possible.
  2. Fields in Red are Required.
  3. Click the "Submit Complaint" button.
  4. You should receive an e-mail confirmation of your report to the e-mail address you provide.

A. Date Submitted:

First Name: Last Name:
Address 1:
Address 2:
City: State: Zip:

Day Phone: Evening Phone:

E-Mail:

Re-enter E-Mail:

Description of Complaint and Action Requested:

With whom have you previously addressed this problem? Examples: Property Owner, Councilman, City Official, Tenant/Resident, Other, No One. Please give names and addresses when available.

City Councilman Referred To:

B. Additonal Comments From Councilman

Date Referred:

City Department Referred To? Examples: Bldg Inpec, Planning, Police, Fire, Health, Mayor's Office, Parks & Recs, Street, Sanitation, Other

C. Additional Comments From City
Person Responding:
 Response Date:
Resolution of Complaint/Actions Taken
City Councilman: City Official:
Date Resolved:
 

 

Kanawha City Community Association, Inc. | Post Office Box 4423 Charleston, WV 25364 | info@kanawhacity.org

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