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Complaint Form

 Form Web Part

Consumer Information Information about you. We do not publish your identity but must have it for our records. Reports become the property of The City of Cedartown. Please be accurate and fair in your comments. Remember, you are responsible for what you write!

Fields with an asterisk* are required

*Your name

*Your Address

*City

*State

*Zip

 

*E-mail

Home phone

Work phone

Perpetrator The residence, property, company, or store that you are complaining about. Please be exact. Many businesses have similar names.

*Business Name

Individual you dealt with, if any

Address

City

State

Zip

 

Telephone

*What is your complaint? Use as much space as you need.