E-Gov Services Village of Antioch

Street Light Out

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Purpose. Use this form to nofity of street light that is not lighting properly.

* Information is required.

Contact Information

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

* What is the exact address of the light?

If known, please include the street light pole tag number.

Describe the problem

Attach a Picture or File (max size: 30MB):

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* Information is required.

Notes:

If you send us a message, you will receive a Tracking Number allowing you to follow-up with your request, at your convenience. Responses may be delayed dependent on staffing. If this is an urgent matter, please call Village offices at 847-395-1000.

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