Form Center

2. Name*
3. Email Address*
5. Address*
6. City*
7. Phone Number*
9. Type of Damage*

   1. Mailbox
   2. Yard
   3. Both
11. Date Damage Occurred*
    Date Damage Occurred

    Please enter the date that damage occurred to your mailbox as a result of Grand Blanc Township DPW plowing and or salting.

13. Temporary Mailbox Needed*

    1. Yes
    2. No
15. Does your neighborhood have an HOA that requires a specific mailbox?*

    1. Yes
    2. No
    3. N/A
17. If a yard repair is needed, will the repair require seed or sod?

    1. Seed
    2. Sod
19. If a yard repair is needed, does your yard have sprinkler heads near where the plow damaged the yard?

    1. Yes
    2. No
21. Mailbox Replacement Policy
    Policy
Leave This Blank:


23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

* indicates a required field