Village Complaint/Comment Form

2. If the complaint is Police Department related, please disregard this form and contact the Police at 608-839-4652.

   If the complaint is Police Department related, please disregard this form and contact the Police at 608-839-4652.

4. Process
   Village staff will review the complaint and make an initial determination. Complaints may be forwarded to the appropriate Village Committee or Commission by a Department Head. The decision made at the Committee level shall be deemed final unless the complainant appeals the decision to the Village Board.

   Village staff will review the complaint and make an initial determination. Complaints may be forwarded to the appropriate Village Committee or Commission by a Department Head. The decision made at the Committee level shall be deemed final unless the complainant appeals the decision to the Village Board.

6. Date
   Date

8. Name*

10. Address*

12. City*

13. State*

14. Zip Code

16. Phone

17. Email

19. Description of Complaint*

    Please provide photos or a diagram if applicable.

21. Upload Photos or Diagram

23. Please describe why you believe the above complaint is a matter that the Village is obligated to address:

25. Please describe your desired outcome to this complaint:

27. Internal Comments/Actions:

29. Reffered to Committee

    1. Yes
    2. No

30. Please enter the scheduled date and time of the meeting:
    Please enter the scheduled date and time of the meeting:

    Please enter the scheduled date and time of the meeting:

32. Please add the location of the meeting:

34. Committee Decision

Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field