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2. Person Filing Complaint
4. Contact Phone Number
5. Date of Complaint
   Date of Complaint
7. Location of Complaint
   Specific intersection, 4 way stop, street, direction of travel, etc.
9. Complaint Zoning

   1. Commercial
   2. Construction Zone
   3. Residential
   4. School Zone
   5. Other (briefly specify)
10. If Other, please briefly specify.
12. Type of Complaint

    1. Crosswalk Violation
    2. Parking
    3. Red Light Violation
    4. Speed
    5. Stop Sign
    6. Other (briefly specify)

    Check all that apply or specify.
13. If Other, please briefly specify.
15. Time of Day Occurring
    Time of Day Occurring
    Specify hours of day, not just morning/night.
17. Is there specific vehicle(s) involved?

    1. Yes
    2. No - all vehicles in general.
18. If Yes, please describe vehicle(s).
    Include make, model, color of vehicle, license plate, male or female driver and description if possible.
20. Thank you for filing a traffic complaint report. This reporting system is for non-emergency incidents. If you have an emergency, dial 911. With the information provided from this form, officers will be advised of your issue or concern. When time and call load permits, officers will randomly conduct traffic saturation patrols in your area of concern. If you need assistance please call the Township of Bloomfield Police Department non-emergency line at 973-680-4141.
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24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field