2. Traffic Complaint Report Form
   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.
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21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

* indicates a required field