Traffic Complaint

2. Traffic Complaint Report Form
   Please complete the form below, you may be contacted by a supervisor at Worthington Police for additional information.

   Please complete the form below, you may be contacted by a supervisor at Worthington Police for additional information.

4. First Name*

5. Last Name*

6. Return email address*

8. Address1*

10. City*

11. State*

12. Zip*

13. Phone Number

15. Location of complaint*

    Please provide a detailed description of the location of the complaint

17. Nature of complaint*

    Please provide a detailed description of the type of traffic complaint. For example, drivers running stop sign going West on Anystreet

19. Day(s) of the week and time(s) for complaint*

    Please be specific. For example Monday - Friday 6am-8am. Complaints with "All day, every day" will be given lowest priority for enforcement actions.

Leave This Blank:


20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

* indicates a required field