906 S. White Oak Road, White Oak, TX 75693
Phone: 903-759-6615 Fax: 903-297-3452
CODE ENFORCEMENT COMPLAINT FORM
Please complete this form and return it to the above address. Provide as many relevant details as possible including
specific address. A SIGNED COMPLAINT FORM IS NECESSARY BEFORE THE CODE ENFORCEMENT OFFICE
CAN INVESTIGATE, UNLESS A LIFE THREATENING ISSUE EXISTS OR IF ITS IS OTHERWISE DEEMED
APPROPRIATE TO ACT.
Section 1. COMPLAINT LOCATION INFORMATION
ADDRESS OF PROPERTY COMPLAINT:
If you do not know the specific address be as descriptive as possible about its location. For example: the south west
corner of X & Y street…or…2 houses east of my address…or…3
rd
lot in from the corner of X & Y on the north side of
the street, etc.
IF KNOWN:
PARCEL NUMBER____________________________ PROPERTY OWNER
NAME OF RESIDENT__________________________________ PHONE NUMBER______________________________
Section 2. COMPLAINT SUMMARY How long has the violation existed? ______________________
□ Garbage/debris □ Zoning Violation □ Substandard Building
□ Junk Vehicles Most common examples include: Please describe on reverse side
□ Parking in the front yard Examples include:
□ Tall dry vegetation □ Too many/prohibited animals □ Broken Windows
Fire Hazard □ Illegal Home Business □ Fire damaged building
□ Continuous Yard Sale □ Leaning Walls
□ Other □ Living in camper/RV □ Sagging or holes in roof
______________________ □ Sign code Violation □ Missing doors
□ Building setback violation
Please use the back of the form for details, any explanations or additional complaints
Section 3. COMPLAINT INFORMATION
Print your name _________________________________________________________________________________
Your Address ___________________________________________________________________________________
Zip Code _________________ Home Phone _________________________ Work Phone ______________________
Confidentiality preference: Disclosure of information revealing your identity will depend on application of the public
disclosure law, Texas Government Code § 552.101 Texas PIA, other applicable statutes and whether the complaint is
criminally prosecuted. Please initial in the space that indicates whether you desire information revealing your identity
be disclosed. Failure to initial will result in information being subject to disclosure. By checking Do Not Disclose I
am indicating that the disclosure of my name would endanger my life, physical safety or property.
_____ Do Not Disclose _____ You May Disclose
Initial Initial
SIGNATURE_______________________________________________________ DATE________________________
click to sign
signature
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