Complaint Form

APPENDIX 2
Lafayette County, Mississippi
WRITTEN COMPLAINT FORM
REQUESTING INVESTIGATION OF UNLAWFUL LITTERING OR DUMPING


PURPOSE:

The purpose of this form is to assist citizens of Lafayette County to submit written complaints to the county Solid Waste Enforcement Officer. Use of this form is optional and written notice does not have to be given on this form.

INSTRUCTIONS:

  1. Fill in date, property address, and complainant information below.
  2. Provide a brief description of the problem. (Include photographs if possible.)
  3. Deliver this complaint form to:
    Lafayette County Solid Waste Enforcement Officer
    Lafayette County Chancery Building
    300 N. Lamar Blvd.
    Oxford, MS 38655
    (If by mail, P.O. Box 1240, Oxford, MS 38655)

All fields marked with an asterisk (*) are required.


Problem Information

I am requesting an investigation by the Lafayette County Solid Waste Enforcement Officer of the property at the following address:
Address*

Problem Description*

Complainant Information

Name*

Email*

Address*

City, State, ZIP*


Upload Photograph (1MB file upload limit, JPG, PNG, GIF, PDF only)


Signature (type your name)*