CITY OF EASTHAMPTON • MASSACHUSETTS
MUNICIPAL COMPLAINT FORM
COMPLAINANT INFORMATION
(If you prefer to place a complaint anonymously, please be aware that it will not be investigated.
All complaints are subject to Public Records Requests)
Name: ——————————————————————————————————-—————
Address: ————————————————— City: ——————————————————
Phone: —————————————- E-mail: ————————————————————
Today’s Date: ——————————-
Date & Time of Incident: ———————————————————————————
DESCRIPTION OF COMPLAINT (Please document as thoroughly and completely as you can
and attach additional pages, if necessary)
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Return completed forms to : City of Easthampton Human Resources Department
50 Payson Avenue
Easthampton, MA 01027
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