Village of Kingsley
207 S. Brownson
Kingsley, Michigan 49649
Phone: (231) 263-7575

Please provide as much of the following information as possible.

Date:


Problem / Complaint

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Information pertaining to the property in which the complaint is in reference to.

Property Owner:


Property Address:


Parcel # (if known):

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Person(s) Filing the Complaint.

Complaintant's Signature:


Complaintant's Address:


Complaintant's Phone Number:


Complaintant's Email Address: (required)