Port Jefferson, NY · Suffolk County
Complaint Form
The Complaint Form lets people report a concern to the Port Jefferson Building & Planning Department by providing details about the complainant, property, and complaint.
What this form is
Use this form to provide the complainant’s name, contact information, the building and property identifiers, the name of the person the complaint is against, and a description of the complaint. It also includes spaces for the date, time, action taken, and the person who received it. The form states that false statements are punishable as a Class A misdemeanor and asks the complainant to read and acknowledge that statement.
Who needs it
People who want to report a complaint involving a building or property in Port Jefferson can use this form to provide the relevant details.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This form is completed without a notary; the complainant signs and dates it and marks that they read and acknowledged the statement about false statements.
How to submit this form
- 1
Download the Form
Download the Port Jefferson Complaint Form PDF.
- 2
Complete the Form
Fill in the complainant and property details, identify the person the complaint is against, and describe the complaint.
- 3
Review and Acknowledge
Review the statement about false statements, then mark that you read and acknowledged it and date the form.
- 4
Submit to the City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What information does the Complaint Form ask for?
- It asks for the complainant’s contact details, building and property identifiers, the name of the person the complaint is against, a complaint description, and other fields.
- Who can use the Port Jefferson Complaint Form?
- People who want to report a complaint can use the form to provide information about the complainant, building, property, and person the complaint is against.
- Do I need a notary for the Port Jefferson Complaint Form?
- No. This form has no notary block; the complainant signs and dates it and marks that they read and acknowledged the statement about false statements.
- How do I submit the Port Jefferson Complaint Form?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Complaint Form doesn’t need a notary — but if you have another Port Jefferson form that does, a commissioned online notary can help.