E-Gov Services Village of Grayslake

Snow Plowing - Mailbox Damage

Click here to Login | Click here to Register

Purpose. This form is used to request a mailbox repair by Public Works or request a check in the amount of $50.00 for a new mailbox to be installed by the homeowner.

Note: Depending on the nature of your repair, a permanent fix may not be made until weather permits.

* Information is required.

Contact Information

* First Name:
* Last Name:
Business Name:
Email:
* Daytime Phone:	() –
Fax:	() –
* Address:
City:
State:
ZIP:

Mailbox Location:

If the address is the same as above, please reenter the address here.

* Address:	- Or Other Not Listed -
Unit:

	Provide any additional information on the location in the box below.

* Check all that apply:

Make repairs to existing mailbox

Replace damaged mailbox with standard mailbox

Repair damaged mailbox post

Send check for $50.00, I will install a new mailbox

Other information...

Check here to have email confirmation of this request sent.

* Information is required.

Notes:

Upon submitting a request, you will receive a tracking number which may be used to follow up with your request at a later date. If an email address is provided, you may choose to receive a copy of your request via email which includes this tracking number.

Information we receive may be considered public information which is subject to disclosure under current state law. Learn more about our Privacy Policy.

Internal Use Only, Leave Blank:
Please leave this field blank and remove any values that have been populated for it.