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Violation Complaint Form
Conceal Carry Violation Complaint Form
* = Required
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Last Name
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First Name
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Title
Mr.
Mrs.
Ms.
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Address
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City
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State
Please Select a State
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OR
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Zip
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Organization
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Phone
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Email
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Please give a description of your request
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Name of the building where the complainant observed or received the notice:
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Name of the state agency or political subdivision that owns or occupies the building where the complaint observed or received the notice:
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Physical address of the building where the complainant observed or received the notice:
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Date the complainant observed or received the notice:
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Description of where is the sign located on the premises? Please provide as much detail as possible:
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What is the building generally used for?