What is TODAY's date?*

Street Address of Hazard:*

City/Town*

Date Hazard was Noticed:*

Description of Hazard:*

Describe your concern here.

Is the property vacant? *

Yes

No

Excessive weeds?*

Yes

No

What is your name?

What is your phone number?

What is your e-mail address?

Your information will be e-mailed to the Frederick County Fire Marshal's Office located at 5370 Public Safety Place, Frederick, MD 21704. Phone: 301-600-1479

Please indicate on the form if you would like to speak to someone from the Fire Marshal's Office regarding your concern.