Please complete the information below to submit complaints of environmental pollution. Only completed information will be replied.

Note: Fields marked with * are mandatory

COMPLAINANT INFORMATION
Name :  * 
MyCard No./Passport:  *  Example :666666224444
Age:  * 
Race:  * 
Nationality:  * 
Tel. No:  *  Example :0355447892
Email:  * 
Complainant's Address:  * 
 
COMPLAINT INFORMATION
Query Options:
Referred State:  * 
Complaints Title:  * 
Type of Polution:  * 
Cause by: * 
Location
Coordinat(If exist):


Date/Time Of Occurence:     * 
 
Place Description Of Occurence:  *  Example :Adjacent to the school building / in front of the main road
Complain's Description:  * 
Attachment:   Can upload more than one file,
                                                 Maximum File Size is 10MB
File:

Format that is accepted : jpg, gif, png, doc, docx, xls, xlsx, ppt, pptx, pdf.

 
All personal information and details of complaint submitted by me are correct and I am responsible for it.
If the Department finds that your complaint is false, the Department have the right to make a police report upon it.

*I have read and agree to the matters specified.
Verification Code  *