Damage report

I hereby give notice of the following defects in the urban area...

On roads, cycle paths, footpaths, parking lots, etc:

On street lighting and other electrical installations:

At public fountains and toilet facilities:

In public facilities:

In cemeteries:

On municip. buildings:

Playground facilities:

Other damage:

If the damage is not included in the list, you can describe it here:

I saw the above-mentioned defect/damage on:

Location of damage (please provide a precise description of the location, the place to which this report relates:

Here you can upload images (all common image files up to a size of 10 MB) of the damage.

Salutation

First name

Last name

Street

House number

ZIP CODE

Location

Telephone

E-mail address

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