Service Request Form

For this or future service requests, use the form below to quickly and easily submit your complaints. Manhattan Community Board Six (CB6) works with government agencies and elected officials to help resolve problems in our community.

Name

Please include your first and last name.

Location of the Issue

Please write down the location of the issue (an address, an intersection, etc.)

Description of the Issue

Please describe the issue you're experiencing. Give as many details as you can, including who/what is causing the issue, when the issue is happening, and how it is happening.

{name}

Please submit your email address, so that we can get in touch with you.

Phone Number

Please submit your phone number, so that we can call you about this issue, if necessary.

311 ID#

If you've contacted 311 about this issue, please indicate the 311 number you got when you submitted your request.

Attachments

Please submit any photos or videos showing the condition, if you have any.

Attach file

Drop files here

Do not submit passwords through this form. Report malicious form

Alert