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GRAFFITI
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Tuesday, March 09, 2010
GRAFFITI ABATEMENT REPORTING FORM
Fields in
RED
are Required
Name:
Phone Number:
Would you like to receive a return call?
Choose One
Yes
No
Please Describe the Location of the Graffiti:
Please Describe the Graffiti:
Is the graffiti located in proximity of a school, church or park?
Choose One
Yes
No
Is there any racial epithets or other profanity?
Choose One
Yes
No
If yes, please describe:
To your knowledge, how long has the graffiti been there?
Choose One
Less Than One Week
Less Than One Month
Less Than Three Months
Greater Than Three Months
I Do Not Know
Do you have any information of the offender?