*DENOTES A REQUIRED FIELD

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


2. Briefly describe your request in the space provided. Please be as specific as possible.
*Description of Problem:






3. Enter the address or location as well as the nearest intersection of the issue that you are
                                        reporting in the space provided.

*Location:






*Name:

*Phone:


Town of Vincent, Alabama                  25 Florey Street, Vincent, AL 35178  
Phone (205) 672-2261 - Privacy Policy
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