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2. Location of Concern
4. Address
6. Additional Location Details

   If you are unable to provide an exact address, please include nearby landmarks, cross streets, or other descriptive information to help locate the area of concern.

9. Date of Incident*
   Date of Incident

   Date of Incident
10. Type of Issue

    1. Littering from Vehicles
    2. Roadside Trash or Debris
    3. Illegal Dumping

    1. Litter in Public Space
    2. Hazardous Waste or Dangerous Materials

    1. Overflowing Dumpsters
    2. Other
12. Vehicle Descriptive Information

    If you witnessed littering from a vehicle, please complete the applicable fields. This information can assist authorities in addressing the issue.

14. Make
15. Model
16. Approximate Year
17. Color
19. Tag Number
20. Description of Litter
22. Photo/Video Upload

    You may upload a photo or video to help KEB better understand the concern or to provide assistance for authorities, should prosecution be pursued.

    Please ensure the image clearly shows the littering incident or area.

    Accepted file types include JPG, PNG, PDF, and MP4 (video). The maximum file size is 10 MB.

    Only photos and videos directly related to littering incidents should be uploaded. Submitting inappropriate or unrelated files is prohibited and may result in further action.

24. Additional Details or Comments
28. Contact Information

    Providing your contact details allows us to follow up if needed. All information is kept confidential.

30. Your Name
31. Phone Number
33. Email Address
35. Address
36. Date of Form Submission
    Date of Form Submission

    Please complete this field if the date you're submitting the litter report is different than the date of the littering incident.

Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field