E-Gov Services Village of Antioch

WARNING! Please do not use this form to report issues of an emergency nature or for conditions requiring an immediate response. After 3:30 p.m. and before 7:00 a.m., please call (847)395-8585, which is our dispatch service.

Sewer General

Click here to Login | Click here to Register

Purpose. This form is used to communicate with city personnel to request services and request information.

* Information is required.

Contact Information

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

* Nature of the request/suggestion...

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

Add Another FIle

CAPTCHA

Check here to have email confirmation of this submission.

* 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.