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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
    9. Traffic/Road signs

    1. Hazardous parking
    2. Storm sewer leaking/blockage
    3. Loose/protruding manhole cover
    4. Water Quality Concerns
    5. Sanitary Sewer Concerns
    6. Electrical Power Concerns
    7. Utility Billing/Payment Issues
    8. Tax Billing/Payment Issues
    9. 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