ABRA Formal Complaint Form
This formal complaint form can be submitted anonymously to ABRA about issues concerning establishments that serve alcohol.
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Complainant Information
Full Name
Full Address (Street, City, State, Zip Code)  
Phone Number
Email
Would You like to be contacted *
Establishment Information
Establishment Name *
Establishment Address (Street, City, State, Zip Code)   *
Date of Incident *
MM
/
DD
/
YYYY
Time of Incident *
Time
:
Type of Complaint *
Required
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