TOWN OF NEWTON
SUGGESTION/COMPLAINT FORM
DATE ____________________________
BRIEF DESCRIPTION OF SUGGESTION OR COMPLAINT
BRIEF SUGGESTION FOR REMEDY, IF KNOWN:
NAME AND/OR ADDRESS SUGGESTION/COMPLAINT PERTAINS:
**IF YOU REQUEST A WRITTEN REPORT BACK ON THE ABOVE ISSUE, THEN SIGN BELOW AND INCLUDE AN ADDRESS AND PHONE NUMBER. PLEASE BE AWARE THAT THIS IS A MATTER OF PUBLIC RECORD AND A COPY OF THIS FORM WILL BE GIVEN OUT IF REQUESTED.
____________________________________________________________________________________
SUBMITTED BY: ADDRESS:
____________________________________________________________________________________
TELEPHONE NUMBER DATE
For Selectmen’s Office Use Only
Copied & forwarded to: _________________________________ Date: _____________________
Follow-up letter sent on: ___________________________________________________________
Inspection Appointment Set for (if applicable) __________________________________________
Final decision reached: ____________________________________________________________
Final letter sent: ____________________________________________________________
Closed on: ____________________________________________________________
Amended: December 11, 2001
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