Talladega: Action Center

Action Center

* DENOTES A REQUIRED FIELD

	1. Select the type of issue that you are reporting.
*Nature of the issue:

	2. Briefly describe your request in the space provided. Please be as specific as possible.
*Description of the issue:
	3. Enter the address or location as well as the nearest intersection of the issue that you are reporting in the space provided.
*Location:
	Contact Information:
*Name:
*E-Mail:
*Address:
*City:
*State:
*Zip Code:
Home Phone:
Work Phone:
Cell Phone: