Health Nuisance
Complaint Form
Please return this form to: info@adc.govt.nz or Ashburton District Council, PO Box 94, Ashburton 7740
Complainant Details
Name:
Trading Name:
Postal Address:
Phone Number:
Email:
Fax:
Complaint Details
Date:
Type of Complaint:
Person Causing Complaint:
Location of Complaint:
Further Information:
Action Taken by Council (office use only)
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