Complaint Form for Diesel Fleet or Vehicle
Please note: in order to maintain anonymity, most of the information requested on this form is not mandatory. However, ARB will be able to take action more effectively if as much information is provided as possible. Required fields contain an asterisk (*) and either Vehicle license plate(*) or Company name(*). Please answer questions and click "Submit Form".

Complaint Description
Where the vehicle was observed:
Address:
(Cross streets if no address)
City:
Date and time the vehicle was observed:
*Nature of Complaint:
( Please include as much information as possible)
Vehicle type:
Vehicle make and model:
*Vehicle license plate or VIN#
Upload a photo
If possible, upload an image. File must be in JPEG, GIF, PNG, or BMP format and can not exceed 4Mb.

Company Information
*Company name:
Company phone:
Company email:
Company address:
Contractor license #:
MC, CA, and/or USDOT #:
Additional identifying information:
(If the owner is unknown, was there any other identifying information available, such as signs or logos?)

Complainant Contact Information
To contact in case additional information is needed to further investigate this complaint.
THIS INFORMATION WILL REMAIN CONFIDENTIAL
Complainant Name:
Complainant Phone:
Complainant email: