Wise County Litter Control – "Report A Litter Bug" eForm

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Disclaimer:    All information provided to our office by you will be kept strictly confidential.
The violater will never be told the identity of the complainant.

(Note:  *** Indicates a Required Field)

Your Contact Information:

Name
E-mail
Telephone
FAX

What Type of Complaint Do You Want to Send?

***

When did the Incident Occur? :

*** Date (mm/dd/yyyy): 
*** Time (hh:mm):        

Enter Details of the Incident Below:

           *** ( Location?  Person(s) involved, if known?  What you observed?  Any other details? )

Contact You Regarding this Complaint?

Yes No