I, the complainant, acknowledge the following:

1. I am a resident, owner, or property manager at a multi-unit residence within Alameda County.

2. I understand that any information or record submitted may be subject to public disclosure.

3. If I live in a City or unincorporated area of the County of Alameda, where an administrative citation is issued, and the recipient(s) appeals, I may be called to testify at an administrative appeal hearing. I agree to make myself available to testify and understand that if I fail to testify, the citation may be dismissed.

Please type your full name below: