Fire - Complaint - File Complaint · DCA Service Portal (UAT)

Please indicate the nature of your complaint

Please select a Training/Certification complaint type:

Please indicate Fire Code Enforcement complaint type

Please enter the name of the Fire department/fire academy/training location

Please include the name of the individual

Fire Department Team

Contractor Company Name

Contractor / Employee Name, if known

Permit Number, if known

Member Name

County

Municipality

Fire District

Property Interest

Business Name

Street Address

Building

Please fill in the description box below the exact nature of the complaint (ex: I noticed the fire alarm box had no power)

Have you filed additional complaints regarding this issue with other individuals or agencies regarding this complaint?

NoYes

If Yes, please list who

Do you wish to remain anonymous?

NoYes

Organization Name

First Name

Last Name

Business Phone

Mobile Phone

Address Line 1

Address Line 2

Address Line 3

City

State

Zip Code

Attach a file