Town of Coaldale - Traffic Complaints Portal

Traffic Complaints Portal
Contact Information
Name*

First NameLast Name
Home Address*

Street Address

Street Address Line 2

CityProvince

Zip CodeCountry
Email*
example@example.com
Phone Number
Please enter a valid phone number.

Vehicle Information
Select the type of vehicle*
Make
Acura, Honda, BMW, etc.
Model
TL, CR-V, Camry, etc.
Colour
Red, Black, White, etc.
License Plate No.
Vehicle Description

Incident Description
Please enter a detailed description of the incident or your concern. *

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