Complaint Form for Red Lion Borough Residents ONLY
Traffic Light or Street Light Out

Your e-mail address:              
     (required)

What do you want to report?
Traffic light problem
Street light problem

Location of problem: 
(Use an address and/or cross streets to describe the location)

Describe in detail the problem with the light that you are reporting.
Be sure to give specific details about the location of the light, including
     the direction you are facing when you are looking at the light.

OPTIONAL INFORMATION:

Your name and address are optional and used only to reply to your concerns.

Title:  Mr. Mrs. Ms.      First Name:       Last Name: 

Address: 

City:       State:       Zip Code: 

Daytime Phone Number:         
(xxx-xxx-xxxx)  

Evening phone number:             
(xxx-xxx-xxxx)