Online Service Request and Complaint Form: Housing

Instructions: Please enter as much information as possible. Items with * are required fields. Any information you provide is confidential. You may choose to remain anonymous, however please enter a valid e-mail address and telephone number in case we need to contact you for more information. When you are finished click the "Submit" button. If you prefer to file a complaint by phone, please call (716) 961-6800. Thank you.

Address

City/Town

State/Province

ZIP/Postal Code

Unit # or description (upper, lower, front, rear)

Number of units are in the building

Are there children under age six living in the unit?

Do you know who owns this building?

Owner's First Name

Owner's Last Name

Owner's Address

City/Town

State/Province

ZIP/Postal Code

Owner's Phone Number

Your First Name

Your Last Name

Your Phone Number

Your Email Address

Description of Problem (150 words or less)

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