NTA GENERAL COMPLAINT FORM
*NAME (LAST, FIRST, MI):
ALTERNATE PHONE NUMBER:
DETAILS OF COMPLAINT
PLEASE PROVIDE A DETAILED STATEMENT REGARDING YOUR COMPLAINT AND THE NATURE OF THE RELIEF SOUGHT.
DO NOT OMIT ANY FACTS, AS ALL INFORMATION MAY BE RELEVANT TO OUR INVESTIGATION.
EMAIL ANY DOCUMENTATION WHICH MAY SUPPORT YOUR CLAIM (PHOTOS, INVOICES, ETC.) TO NTA@NTA.NV.GOV
THE NEVADA TRANSPORTATION AUTHORITY (NTA) WILL NOT PROCESS ANY UNSIGNED, INCOMPLETE, OR ILLEGIBLE COMPLAINT FORMS
I hereby affirm under
penalty of perjury that I am an adult, 18 years of age or older, that
I have personal knowledge of this matter stated herein, and that the assertions contained in this complaint are true.
Please type your First and Last Name
I understand that checking this box constitutes a legal signature confirming that the information provided herein is true and accurate.
Note: All fields with an asterisk (*) are required to be filled in prior to submitting the form