Your Name: Your Street Address: Your City and Zip Code: Your Home Phone Number: Your Email Address: Location of Traffic Problem: (Required) Provide a street name, or intersection, and closest cross street. Direction of Travel of the Vehicles: North South East West 1) Describe the traffic problem: (Check any boxes that apply or write in a description.) Speeding Stop Sign - Not Stopping Red Light - Not Stopping Making illegal / unsafe left turns Making illegal / unsafe right turns Making illegal / unsafe 'U' turns Blocking intersection Unsafe / illegal merging in traffic Vehicles not stopping for pedestrians Pedestrians crossing un-safely / against signals Illegal parking / stopping - General Parking - Blocking sidewalks Abandoned or junk cars - parked on street or private property Other observer violations: 2) How often does this occur? What times? Mornings - rush hour Afternoons / evenings - rush hour Several times each day All day Every night Week days only Mostly on weekends Several times each week or month Occasionally At any other times? - Please describe: 3) Please describe and other details Use this space to provide us with any details. Please be brief. Describe and driver actions, signs, marking or road problems, violator types or descriptions, violator licens plate number, etc... Do you want to be contacted about the results? (only if you entered your name, phone and email address above.) No - I don't want to be contacted Yes - I want to know what happened