1. Issue type

Please select... Litter Council Maintenance (e.g. faulty street light) Vandalism Anti Social Behaviour Other (please specify)

If 'other', please describe the type of issue:

2. When did it occur?
If what you are reporting occurred at a particular time or appeared on a certain day, etc,
please state give details here:

3. Location
Please give details of where the issue is/was - street name, building, etc:

4. Details
Please describe the issue in full:

5. Reporting to the authorities
If you have reported the issue or incident to North Hertfordshire District Council, the Police, North Hertfordshire Homes or other authority, please give details here.

(If you haven't reported it to a relevant authority already, please consider doing so. This will enable them to formally address the issue).

Reported to:

When reported:

Who reported it (optional):

Detail any reference numbers given to you (and/or who did you speak to?):

6. Date Resolved
If the issue no longer exists or if it has been resolved, please tell us:

When it was resolved:

What action was taken (to your knowledge):

7. About You
Completing this section is entirely optional. Having your details will enable us to contact you to find out more if necessary, and will be used for no other purpose. Your details will be held in the strictest confidence and any matter taken up with the authorities will be presented by The Baldock Society with no reference to yourself.

Your name:

Your email address:

@

Your postal address:

Your telephone number

Please tick this box if you are a member of The Baldock Society >