* indicates a required field

4. Complainant Information
6. First Name*
7. Last Name*
9. Mailing Address*

   PO Box, street

10. Mailing Address Cont:

    Apartment, suite, space, etc.

12. City*
13. State*
14. Zip Code*
16. Physical Address

    If different than mailing address.

18. Telephone Number*
19. Email Address
23. Complaint Information
25. Complaint Issued Against

    Name of individual(s)/business (if known).

27. Mailing Address

    PO Box, street (if known).

28. Mailing Address Cont.

    Apartment, suite, space, etc. (if known).

30. City
31. State
32. Zip
34. Physical Address or Location*

    Location of alleged/potential code violation. 

36. Description/Statement of Complaint or Alleged Violation(s)*

    Provide as much information as possible. 

38. Upload photos and additional evidence here
40. NRS 207.280 False reporting of crimes unlawful:
    
    

    Every person who deliberately reports to any police officer, sheriff, district attorney, or member of the Department of Public Safety that a felony or misdemeanor has been committed, which causes a law enforcement agency to conduct a criminal or internal investigation, knowing such report to be false, is guilty of a misdemeanor. l further understand that if a complaint is issued as a result of this report, (maybe requested 10 testify in court.

44. Internal Use Only
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48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit