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Code Complaint Form

2. City of Flagler Beach
   Code Enforcement Alleged Complain Form

4. Alleged Violation Address

6. City

7. State

8. Zip

10. Description of Alleged Violation

12. Person Filing Complaint

    Or write anonymous

14. Address

16. City

17. State

18. Zip

22. Date of Complaint

23. Case Number

25. Complaint Received

    1. Office Visit
    2. Phone

    1. Other

26. If other, please explain

28. Action Taken

30. Date

31. Report

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56. 1. Receive an email copy of this form.
57. Email address

    This field is not part of the form submission.

58. Submit Submit and Print

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