Use this form if you would like staff at the Village of Homer Glen to address your questions or concerns.

NOTICE:
If you are having trouble submitting this form by email, please print a form from the link below. Fax or mail the completed form to Village Hall.

Water & Sewer Rate Complaint Form for Printing

Fill-In Form for Emailing

Please provide the following information:

Today's date      (mm/dd/yy)

name     

Street Address    

Address (cont.)  

City  

State/Province  

Zip/postal Code  

Day Phone    

Evening Phone    

Cell Phone  

E-mail    

Subdivision:  

Specific Complaint:

(Back to Top)