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2. What is TODAY's date?*
4. Street Address of Hazard:*
6. City/Town*
8. Date Hazard was Noticed:*
10. Description of Hazard:*
    Describe your concern here.
12. Is the property vacant? *

    1. Yes
    2. No
14. Excessive weeds?*

    1. Yes
    2. No
16. What is your name?
18. What is your phone number?
20. What is your e-mail address?
22. Your information will be e-mailed to the Frederick County Fire Marshal's Office located at 5370 Public Safety Place, Frederick, MD 21704. Phone: 301-600-1479

    Please indicate on the form if you would like to speak to someone from the Fire Marshal's Office regarding your concern.
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24. Submit

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