{"id":6,"date":"2026-02-04T20:59:37","date_gmt":"2026-02-04T20:59:37","guid":{"rendered":"http:\/\/slums.draincarrollton.com\/?page_id=6"},"modified":"2026-02-04T20:59:37","modified_gmt":"2026-02-04T20:59:37","slug":"file-complaint","status":"publish","type":"page","link":"https:\/\/slums.draincarrollton.com\/index.php\/file-complaint\/","title":{"rendered":"File Complaint"},"content":{"rendered":"        <form id=\"slc-form\" enctype=\"multipart\/form-data\">\n            <h2>Report a Landlord \/ Rental Property Complaint<\/h2>\n            <p class=\"slc-small\">\n                Required fields are in the first section. Expand other sections to add detail, evidence, and history.\n                Reporter info is stored privately and is not displayed on public case lookup.\n            <\/p>\n\n            <div class=\"slc-accordion\">\n\n                <!-- 1) BASICS (Required) -->\n                <div class=\"slc-acc-item\">\n                    <button class=\"slc-acc-btn\" type=\"button\" aria-expanded=\"true\" aria-controls=\"slc-sec-basics\">\n                        <span>1) Basics (Required)<\/span>\n                        <span class=\"slc-acc-right\"><span class=\"slc-acc-icon\">\u2212<\/span><\/span>\n                    <\/button>\n                    <div id=\"slc-sec-basics\" class=\"slc-acc-panel\">\n                        <div class=\"slc-section-note\">These fields are required to file a complaint.<\/div>\n\n                        <label>Property address *<\/label>\n                        <input type=\"text\" name=\"property_address_line1\" maxlength=\"190\" required>\n\n                        <label>Property address line 2<\/label>\n                        <input type=\"text\" name=\"property_address_line2\" maxlength=\"190\" placeholder=\"Apt \/ unit \/ building (optional)\">\n\n                        <div class=\"slc-grid\">\n                            <div>\n                                <label>City *<\/label>\n                                <input type=\"text\" name=\"property_city\" maxlength=\"120\" value=\"Carrollton\" required>\n                            <\/div>\n                            <div>\n                                <label>State *<\/label>\n                                <input type=\"text\" name=\"property_state\" maxlength=\"60\" value=\"MO\" required>\n                            <\/div>\n                        <\/div>\n\n                        <div class=\"slc-grid\">\n                            <div>\n                                <label>ZIP<\/label>\n                                <input type=\"text\" name=\"property_zip\" maxlength=\"20\">\n                            <\/div>\n                            <div>\n                                <label>Unit #<\/label>\n                                <input type=\"text\" name=\"property_unit\" maxlength=\"60\">\n                            <\/div>\n                        <\/div>\n\n                        <label>Short summary<\/label>\n                        <input type=\"text\" name=\"summary\" maxlength=\"255\" placeholder=\"One sentence summary (optional)\">\n\n                        <label>Full description *<\/label>\n                        <textarea name=\"description\" required maxlength=\"20000\"\n                                  placeholder=\"Describe what happened, conditions, dates, who you contacted, and what the landlord did or didn\u2019t do.\"><\/textarea>\n\n                        <label class=\"slc-small\">\n                            <input type=\"checkbox\" name=\"consent_truthful\" value=\"1\" required>\n                            I certify the information is true to the best of my knowledge. *\n                        <\/label>\n                    <\/div>\n                <\/div>\n\n                <!-- 2) REPORTER -->\n                <div class=\"slc-acc-item\">\n                    <button class=\"slc-acc-btn\" type=\"button\" aria-expanded=\"false\" aria-controls=\"slc-sec-reporter\">\n                        <span>2) Your Information (Private)<\/span>\n                        <span class=\"slc-acc-right\"><span class=\"slc-acc-icon\">+<\/span><\/span>\n                    <\/button>\n                    <div id=\"slc-sec-reporter\" class=\"slc-acc-panel slc-hidden\">\n\n                        <div class=\"slc-grid\">\n                            <div>\n                                <label>First name<\/label>\n                                <input type=\"text\" name=\"reporter_first_name\" maxlength=\"120\">\n                            <\/div>\n                            <div>\n                                <label>Last name<\/label>\n                                <input type=\"text\" name=\"reporter_last_name\" maxlength=\"120\">\n                            <\/div>\n                        <\/div>\n\n                        <div class=\"slc-grid\">\n                            <div>\n                                <label>Email<\/label>\n                                <input type=\"email\" name=\"reporter_email\" maxlength=\"190\">\n                            <\/div>\n                            <div>\n                                <label>Phone<\/label>\n                                <input type=\"tel\" name=\"reporter_phone\" maxlength=\"60\">\n                            <\/div>\n                        <\/div>\n\n                        <label>Mailing address line 1<\/label>\n                        <input type=\"text\" name=\"reporter_address_line1\" maxlength=\"190\">\n\n                        <label>Mailing address line 2<\/label>\n                        <input type=\"text\" name=\"reporter_address_line2\" maxlength=\"190\">\n\n                        <div class=\"slc-grid\">\n                            <div><label>City<\/label><input type=\"text\" name=\"reporter_city\" maxlength=\"120\"><\/div>\n                            <div><label>State<\/label><input type=\"text\" name=\"reporter_state\" maxlength=\"60\"><\/div>\n                        <\/div>\n\n                        <label>ZIP<\/label>\n                        <input type=\"text\" name=\"reporter_zip\" maxlength=\"20\">\n\n                        <div class=\"slc-grid\">\n                            <div>\n                                <label>Preferred contact<\/label>\n                                <select name=\"reporter_preferred_contact\">\n                                    <option value=\"\">Select\u2026<\/option>\n                                    <option value=\"email\">Email<\/option>\n                                    <option value=\"phone\">Phone<\/option>\n                                    <option value=\"either\">Either<\/option>\n                                    <option value=\"mail\">Mail<\/option>\n                                <\/select>\n                            <\/div>\n                            <div>\n                                <label>Best time to contact<\/label>\n                                <input type=\"text\" name=\"reporter_best_time\" maxlength=\"120\" placeholder=\"e.g., weekdays after 5pm\">\n                            <\/div>\n                        <\/div>\n\n                        <div class=\"slc-grid\">\n                            <div>\n                                <label>Are you a tenant at the property?<\/label>\n                                <select name=\"reporter_is_tenant\">\n                                    <option value=\"1\">Yes<\/option>\n                                    <option value=\"0\">No<\/option>\n                                <\/select>\n                            <\/div>\n                            <div>\n                                <label>Relationship (if not tenant)<\/label>\n                                <input type=\"text\" name=\"reporter_relationship\" maxlength=\"190\" placeholder=\"neighbor, family, advocate, etc.\">\n                            <\/div>\n                        <\/div>\n\n                        <label class=\"slc-small\">\n                            <input type=\"checkbox\" name=\"reporter_anonymous_public\" value=\"1\">\n                            Keep my name off any public-facing display (public lookup already hides it).\n                        <\/label>\n\n                        <label class=\"slc-small\">\n                            <input type=\"checkbox\" name=\"consent_contact\" value=\"1\">\n                            You may contact me for clarification.\n                        <\/label>\n\n                        <label class=\"slc-small\">\n                            <input type=\"checkbox\" name=\"consent_share_with_agencies\" value=\"1\">\n                            You may share this complaint with relevant agencies as needed.\n                        <\/label>\n                    <\/div>\n                <\/div>\n\n                <!-- 3) PROPERTY DETAILS -->\n                <div class=\"slc-acc-item\">\n                    <button class=\"slc-acc-btn\" type=\"button\" aria-expanded=\"false\" aria-controls=\"slc-sec-property\">\n                        <span>3) Property Details<\/span>\n                        <span class=\"slc-acc-right\"><span class=\"slc-acc-icon\">+<\/span><\/span>\n                    <\/button>\n                    <div id=\"slc-sec-property\" class=\"slc-acc-panel slc-hidden\">\n\n                        <div class=\"slc-grid\">\n                            <div>\n                                <label>Property type<\/label>\n                                <select name=\"property_type\">\n                                    <option value=\"\">Select\u2026<\/option>\n                                    <option value=\"house\">House<\/option>\n                                    <option value=\"apartment\">Apartment<\/option>\n                                    <option value=\"duplex\">Duplex<\/option>\n                                    <option value=\"mobile_home\">Mobile home<\/option>\n                                    <option value=\"room\">Room \/ shared<\/option>\n                                    <option value=\"other\">Other<\/option>\n                                <\/select>\n                            <\/div>\n                            <div>\n                                <label>Occupancy<\/label>\n                                <select name=\"property_occupancy\">\n                                    <option value=\"\">Select\u2026<\/option>\n                                    <option value=\"occupied\">Currently occupied<\/option>\n                                    <option value=\"vacant\">Currently vacant<\/option>\n                                    <option value=\"moved_out\">Moved out<\/option>\n                                <\/select>\n                            <\/div>\n                        <\/div>\n\n                        <div class=\"slc-grid\">\n                            <div><label>Move-in date<\/label><input type=\"date\" name=\"property_move_in_date\"><\/div>\n                            <div><label>Move-out date<\/label><input type=\"date\" name=\"property_move_out_date\"><\/div>\n                        <\/div>\n                    <\/div>\n                <\/div>\n\n                <!-- 4) LANDLORD -->\n                <div class=\"slc-acc-item\">\n                    <button class=\"slc-acc-btn\" type=\"button\" aria-expanded=\"false\" aria-controls=\"slc-sec-landlord\">\n                        <span>4) Landlord \/ Management<\/span>\n                        <span class=\"slc-acc-right\"><span class=\"slc-acc-icon\">+<\/span><\/span>\n                    <\/button>\n                    <div id=\"slc-sec-landlord\" class=\"slc-acc-panel slc-hidden\">\n\n                        <div class=\"slc-grid\">\n                            <div><label>Landlord name<\/label><input type=\"text\" name=\"landlord_name\" maxlength=\"190\"><\/div>\n                            <div><label>Company \/ LLC<\/label><input type=\"text\" name=\"landlord_company\" maxlength=\"190\"><\/div>\n                        <\/div>\n\n                        <div class=\"slc-grid\">\n                            <div><label>Phone<\/label><input type=\"text\" name=\"landlord_phone\" maxlength=\"60\"><\/div>\n                            <div><label>Email<\/label><input type=\"text\" name=\"landlord_email\" maxlength=\"190\"><\/div>\n                        <\/div>\n\n                        <label>Mailing address<\/label>\n                        <input type=\"text\" name=\"landlord_mailing_address\" maxlength=\"190\">\n\n                        <div class=\"slc-grid\">\n                            <div><label>City<\/label><input type=\"text\" name=\"landlord_city\" maxlength=\"120\"><\/div>\n                            <div><label>State<\/label><input type=\"text\" name=\"landlord_state\" maxlength=\"60\"><\/div>\n                        <\/div>\n\n                        <label>ZIP<\/label>\n                        <input type=\"text\" name=\"landlord_zip\" maxlength=\"20\">\n                    <\/div>\n                <\/div>\n\n                <!-- 5) LEASE & MONEY -->\n                <div class=\"slc-acc-item\">\n                    <button class=\"slc-acc-btn\" type=\"button\" aria-expanded=\"false\" aria-controls=\"slc-sec-lease\">\n                        <span>5) Lease, Rent & Money<\/span>\n                        <span class=\"slc-acc-right\"><span class=\"slc-acc-icon\">+<\/span><\/span>\n                    <\/button>\n                    <div id=\"slc-sec-lease\" class=\"slc-acc-panel slc-hidden\">\n\n                        <div class=\"slc-grid\">\n                            <div>\n                                <label>Lease type<\/label>\n                                <select name=\"lease_type\">\n                                    <option value=\"\">Select\u2026<\/option>\n                                    <option value=\"written\">Written<\/option>\n                                    <option value=\"verbal\">Verbal<\/option>\n                                    <option value=\"none\">None<\/option>\n                                <\/select>\n                            <\/div>\n                            <div>\n                                <label>Rent amount (monthly)<\/label>\n                                <input type=\"number\" step=\"0.01\" name=\"rent_amount\">\n                            <\/div>\n                        <\/div>\n\n                        <div class=\"slc-grid\">\n                            <div><label>Lease start<\/label><input type=\"date\" name=\"lease_start\"><\/div>\n                            <div><label>Lease end<\/label><input type=\"date\" name=\"lease_end\"><\/div>\n                        <\/div>\n\n                        <div class=\"slc-grid\">\n                            <div><label>Rent due day (1\u201331)<\/label><input type=\"number\" min=\"1\" max=\"31\" name=\"rent_due_day\"><\/div>\n                            <div><label>Past-due amount<\/label><input type=\"number\" step=\"0.01\" name=\"past_due_amount\"><\/div>\n                        <\/div>\n\n                        <div class=\"slc-grid\">\n                            <div><label>Fees claimed by landlord<\/label><input type=\"number\" step=\"0.01\" name=\"fees_claimed\"><\/div>\n                            <div><label>Security deposit amount<\/label><input type=\"number\" step=\"0.01\" name=\"security_deposit_amount\"><\/div>\n                        <\/div>\n\n                        <label>Security deposit status<\/label>\n                        <select name=\"security_deposit_status\">\n                            <option value=\"\">Select\u2026<\/option>\n                            <option value=\"withheld\">Withheld<\/option>\n                            <option value=\"partial\">Partially returned<\/option>\n                            <option value=\"returned\">Returned<\/option>\n                            <option value=\"unknown\">Unknown<\/option>\n                        <\/select>\n\n                        <label>Utilities included (list)<\/label>\n                        <input type=\"text\" name=\"utilities_included\" maxlength=\"190\" placeholder=\"water, trash, electric...\">\n\n                        <label class=\"slc-small\">\n                            <input type=\"checkbox\" name=\"utilities_issues\" value=\"1\">\n                            Utilities shutoff \/ threats \/ improper billing is part of this complaint\n                        <\/label>\n                    <\/div>\n                <\/div>\n\n                <!-- 6) CATEGORY\/TIMELINE -->\n                <div class=\"slc-acc-item\">\n                    <button class=\"slc-acc-btn\" type=\"button\" aria-expanded=\"false\" aria-controls=\"slc-sec-cats\">\n                        <span>6) Categories, Severity & Timeline<\/span>\n                        <span class=\"slc-acc-right\"><span class=\"slc-acc-icon\">+<\/span><\/span>\n                    <\/button>\n                    <div id=\"slc-sec-cats\" class=\"slc-acc-panel slc-hidden\">\n\n                        <label>Categories (select all that apply)<\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"categories[]\" value=\"habitability\">\n                                Unsafe \/ uninhabitable conditions                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"categories[]\" value=\"repairs\">\n                                Failure to repair \/ neglect                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"categories[]\" value=\"mold\">\n                                Mold \/ moisture                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"categories[]\" value=\"pests\">\n                                Pests \/ infestation                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"categories[]\" value=\"plumbing\">\n                                Plumbing \/ sewage                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"categories[]\" value=\"electric\">\n                                Electrical hazards                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"categories[]\" value=\"heat_hotwater\">\n                                No heat \/ no hot water                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"categories[]\" value=\"security\">\n                                Broken locks \/ security issues                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"categories[]\" value=\"fire_safety\">\n                                Fire safety \/ detectors missing                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"categories[]\" value=\"illegal_entry\">\n                                Illegal entry \/ no notice                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"categories[]\" value=\"harassment\">\n                                Harassment \/ threats                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"categories[]\" value=\"retaliation\">\n                                Retaliation                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"categories[]\" value=\"discrimination\">\n                                Discrimination                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"categories[]\" value=\"utility_shutoff\">\n                                Illegal utility shutoff \/ lockout                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"categories[]\" value=\"deposit\">\n                                Deposit dispute                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"categories[]\" value=\"fees\">\n                                False charges \/ junk fees                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"categories[]\" value=\"eviction\">\n                                Unlawful eviction attempt                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"categories[]\" value=\"other\">\n                                Other                            <\/label>\n                        \n                        <div class=\"slc-grid\">\n                            <div>\n                                <label>Severity<\/label>\n                                <select name=\"severity\">\n                                    <option value=\"\">Select\u2026<\/option>\n                                    <option value=\"low\">Low<\/option>\n                                    <option value=\"medium\">Medium<\/option>\n                                    <option value=\"high\">High<\/option>\n                                    <option value=\"emergency\">Emergency \/ immediate danger<\/option>\n                                <\/select>\n                            <\/div>\n                            <div style=\"padding-top:34px;\">\n                                <label class=\"slc-small\">\n                                    <input type=\"checkbox\" name=\"ongoing\" value=\"1\"> Ongoing issue\n                                <\/label>\n                            <\/div>\n                        <\/div>\n\n                        <div class=\"slc-grid\">\n                            <div><label>First incident date<\/label><input type=\"date\" name=\"first_incident_date\"><\/div>\n                            <div><label>Most recent incident date<\/label><input type=\"date\" name=\"most_recent_incident_date\"><\/div>\n                        <\/div>\n                    <\/div>\n                <\/div>\n\n                <!-- 7) CONDITIONS -->\n                <div class=\"slc-acc-item\">\n                    <button class=\"slc-acc-btn\" type=\"button\" aria-expanded=\"false\" aria-controls=\"slc-sec-conditions\">\n                        <span>7) Habitability & Conditions Checklist<\/span>\n                        <span class=\"slc-acc-right\"><span class=\"slc-acc-icon\">+<\/span><\/span>\n                    <\/button>\n                    <div id=\"slc-sec-conditions\" class=\"slc-acc-panel slc-hidden\">\n\n                        <div class=\"slc-grid\">\n                            <label class=\"slc-small\"><input type=\"checkbox\" name=\"no_heat\" value=\"1\"> No heat<\/label>\n                            <label class=\"slc-small\"><input type=\"checkbox\" name=\"no_hot_water\" value=\"1\"> No hot water<\/label>\n                            <label class=\"slc-small\"><input type=\"checkbox\" name=\"electrical_hazard\" value=\"1\"> Electrical hazard<\/label>\n                            <label class=\"slc-small\"><input type=\"checkbox\" name=\"plumbing_sewage\" value=\"1\"> Plumbing \/ sewage backup<\/label>\n                            <label class=\"slc-small\"><input type=\"checkbox\" name=\"mold\" value=\"1\"> Mold<\/label>\n                            <label class=\"slc-small\"><input type=\"checkbox\" name=\"pests\" value=\"1\"> Pests \/ infestation<\/label>\n                            <label class=\"slc-small\"><input type=\"checkbox\" name=\"broken_windows_doors\" value=\"1\"> Broken windows\/doors<\/label>\n                            <label class=\"slc-small\"><input type=\"checkbox\" name=\"roof_leaks_water_intrusion\" value=\"1\"> Roof leak \/ water intrusion<\/label>\n                            <label class=\"slc-small\"><input type=\"checkbox\" name=\"structural_issues\" value=\"1\"> Structural issues<\/label>\n                            <label class=\"slc-small\"><input type=\"checkbox\" name=\"fire_safety_issue\" value=\"1\"> Fire safety issue<\/label>\n                            <label class=\"slc-small\"><input type=\"checkbox\" name=\"smoke_co_detectors_missing\" value=\"1\"> Smoke\/CO detectors missing<\/label>\n                            <label class=\"slc-small\"><input type=\"checkbox\" name=\"lead_paint_risk\" value=\"1\"> Lead paint risk<\/label>\n                            <label class=\"slc-small\"><input type=\"checkbox\" name=\"sanitation_garbage\" value=\"1\"> Sanitation\/garbage problems<\/label>\n                            <label class=\"slc-small\"><input type=\"checkbox\" name=\"unsafe_common_areas\" value=\"1\"> Unsafe common areas<\/label>\n                            <label class=\"slc-small\"><input type=\"checkbox\" name=\"locks_security\" value=\"1\"> Locks\/security problems<\/label>\n                            <label class=\"slc-small\"><input type=\"checkbox\" name=\"water_quality\" value=\"1\"> Water quality issue<\/label>\n                            <label class=\"slc-small\"><input type=\"checkbox\" name=\"hvac_issue\" value=\"1\"> HVAC\/ventilation issue<\/label>\n                        <\/div>\n\n                        <label>Other conditions (details)<\/label>\n                        <textarea name=\"other_conditions\" maxlength=\"10000\"><\/textarea>\n                    <\/div>\n                <\/div>\n\n                <!-- 8) CONDUCT -->\n                <div class=\"slc-acc-item\">\n                    <button class=\"slc-acc-btn\" type=\"button\" aria-expanded=\"false\" aria-controls=\"slc-sec-conduct\">\n                        <span>8) Landlord Conduct<\/span>\n                        <span class=\"slc-acc-right\"><span class=\"slc-acc-icon\">+<\/span><\/span>\n                    <\/button>\n                    <div id=\"slc-sec-conduct\" class=\"slc-acc-panel slc-hidden\">\n\n                        <label class=\"slc-small\"><input type=\"checkbox\" name=\"illegal_entry\" value=\"1\"> Entered without proper notice \/ permission<\/label>\n                        <label class=\"slc-small\"><input type=\"checkbox\" name=\"harassment_threats\" value=\"1\"> Harassment \/ threats<\/label>\n                        <label class=\"slc-small\"><input type=\"checkbox\" name=\"retaliation\" value=\"1\"> Retaliation<\/label>\n                        <label class=\"slc-small\"><input type=\"checkbox\" name=\"discrimination\" value=\"1\"> Discrimination<\/label>\n                        <label class=\"slc-small\"><input type=\"checkbox\" name=\"shutoff_utilities\" value=\"1\"> Utility shutoff \/ threats<\/label>\n                        <label class=\"slc-small\"><input type=\"checkbox\" name=\"lockout\" value=\"1\"> Lockout<\/label>\n                        <label class=\"slc-small\"><input type=\"checkbox\" name=\"unlawful_eviction_attempt\" value=\"1\"> Unlawful eviction attempt<\/label>\n                        <label class=\"slc-small\"><input type=\"checkbox\" name=\"deposit_dispute\" value=\"1\"> Deposit dispute<\/label>\n                        <label class=\"slc-small\"><input type=\"checkbox\" name=\"false_charges_fees\" value=\"1\"> False charges \/ fees<\/label>\n                    <\/div>\n                <\/div>\n\n                <!-- 9) NOTICE \/ REPAIR HISTORY -->\n                <div class=\"slc-acc-item\">\n                    <button class=\"slc-acc-btn\" type=\"button\" aria-expanded=\"false\" aria-controls=\"slc-sec-notice\">\n                        <span>9) Notice & Repair History<\/span>\n                        <span class=\"slc-acc-right\"><span class=\"slc-acc-icon\">+<\/span><\/span>\n                    <\/button>\n                    <div id=\"slc-sec-notice\" class=\"slc-acc-panel slc-hidden\">\n\n                        <label class=\"slc-small\"><input type=\"checkbox\" name=\"notified_landlord\" value=\"1\"> I notified the landlord \/ management<\/label>\n\n                        <label>Notice method<\/label>\n                        <input type=\"text\" name=\"notice_method\" maxlength=\"120\" placeholder=\"text, email, call, certified letter, portal, in-person\">\n\n                        <label>Notice dates (comma-separated)<\/label>\n                        <input type=\"text\" name=\"notice_dates\" maxlength=\"1000\" placeholder=\"YYYY-MM-DD, YYYY-MM-DD, ...\">\n\n                        <label>Repair requests (what you asked for)<\/label>\n                        <textarea name=\"repair_requests\" maxlength=\"10000\"><\/textarea>\n\n                        <label>Landlord response<\/label>\n                        <textarea name=\"landlord_response\" maxlength=\"10000\"><\/textarea>\n                    <\/div>\n                <\/div>\n\n                <!-- 10) OTHER REPORTS \/ DOC LIST -->\n                <div class=\"slc-acc-item\">\n                    <button class=\"slc-acc-btn\" type=\"button\" aria-expanded=\"false\" aria-controls=\"slc-sec-agencies\">\n                        <span>10) Other Reports & Document Descriptions<\/span>\n                        <span class=\"slc-acc-right\"><span class=\"slc-acc-icon\">+<\/span><\/span>\n                    <\/button>\n                    <div id=\"slc-sec-agencies\" class=\"slc-acc-panel slc-hidden\">\n\n                        <label>Agencies or organizations contacted (free text)<\/label>\n                        <textarea name=\"contacted_agencies\" maxlength=\"5000\" placeholder=\"City inspector, health dept, police, legal aid, etc.\"><\/textarea>\n\n                        <label class=\"slc-small\"><input type=\"checkbox\" name=\"has_documents\" value=\"1\"> I have supporting documents<\/label>\n\n                        <label>Document list (what exists)<\/label>\n                        <input type=\"text\" name=\"document_list\" maxlength=\"2000\" placeholder=\"lease, texts, emails, notices, receipts, videos...\">\n                    <\/div>\n                <\/div>\n\n                <!-- 11) DESIRED RESOLUTION -->\n                <div class=\"slc-acc-item\">\n                    <button class=\"slc-acc-btn\" type=\"button\" aria-expanded=\"false\" aria-controls=\"slc-sec-resolution\">\n                        <span>11) Desired Resolution<\/span>\n                        <span class=\"slc-acc-right\"><span class=\"slc-acc-icon\">+<\/span><\/span>\n                    <\/button>\n                    <div id=\"slc-sec-resolution\" class=\"slc-acc-panel slc-hidden\">\n\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"desired_resolution[]\" value=\"repairs\">\n                                Repairs completed by deadline                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"desired_resolution[]\" value=\"inspection\">\n                                City\/County inspection                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"desired_resolution[]\" value=\"penalties\">\n                                Fines \/ enforcement                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"desired_resolution[]\" value=\"relocation\">\n                                Relocation assistance                            <\/label>\n                                                    <label class=\"slc-small\">\n                                <input type=\"checkbox\" name=\"desired_resolution[]\" value=\"rent_abatement\">\n                                Rent abatement \/ credit                            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