Government Report Form Governmental Report Governmental ReportUse this form to report local, county and state agencies, officials and employees who refuse to uniformly enforce the laws or provide public records. Username*1. Enter the Subject/nature of Matter and Location (Be Brief)?2. Enter the Name of Govt. official(s) involved?3. Enter the Date of Initial Complaint seeking enforcement (mm/dd/yyy)? 4. Has this been brought to the attention of supervisors and any outside entities with oversight jurisdiction, and if so, their names and result?5a. Has any legal or other action been taken by you?5b. If yes, explain briefly?6. What is status or result of this action? Check box to have your report published including your name. I certify that I have read and understand FairTrialNJ’s web site and purpose and I hereby give my permission for FairTrialNJ to either publish or refer to this report (without mentioning my name) and expressly hold FairTrialNJ and its officers harmless for said use, and acknowledge that no duty whatsoever is owed me by FairTrialNJ. .
