RESIDENT INFORMATION:

NAME                                                                                                               HOME TELEPHONE NUMBER

STREET ADDRESS  &  MAILING ADDRESS (if different)                             WORK TELEPHONE NUMBER

CITY  /  STATE  /  ZIP     

COMPLAINT:

SIGNATURES:

I understand this complaint form will be presented at the next regular Cando City Council meeting for the Cando City Council to address.   

RESIDENT SIGNATURE                                                                       DATE

X

RECEIVED BY                                                                                        DATE

X

ACTION TAKEN: