Graffiti Removal Notification Form
Use this form to report graffiti within the City of Belen. Please complete all information including your name, phone number and e-mail address so that someone from our staff can contact you, if necessary. This information will be forwarded to the appropriate department as soon as it is received.
Date:
Name:
Address:
Phone Number:
E-Mail Address:
Would you like to be contacted?:
Yes
No
The graffiti is located on:
Sidewalk
Street or Bridge
Public Building
Traffic Sign
Specify other problem:
Location of graffiti:
