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2. The Borough of Milltown Report a Concern Form will help us identify a problem in your area -- and fix it fast. Should a problem require urgent attention, please call us immediately at 732-828-2100 ext. 181. For a police emergency, dial 911.
   Thank you for your assistance!
4. Contact Information
6. First Name*
7. Last Name*
9. Address1*
11. Address2
13. City
14. State
15. Zip
17. Phone Number*
18. Email Address
20. Please indicate the nature of your problem by checking the appropriate box(es) below:
22. *

    1. Pothole
    2. Traffic signals
    3. Property Maintenance Issues
    4. Abandoned vehicles
    5. Chemical discharge
    6. Road striping
    7. Blocked drainage channel
    8. Street Lights

    1. Traffic/Road signs
    2. Hazardous parking
    3. Storm sewer leaking/blockage
    4. Loose/protruding manhole cover
    5. Water Quality Concerns
    6. Sanitary Sewer Concerns
    7. Electrical Power Concerns
    8. Other
24. Other Issue
    Please note the type of issue you are reporting.
26. Brief Description (or other problem not listed)*
28. Location*
Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit Submit and Print

* indicates a required field