MailboxDamageReport

Use this form to report mailbox damage only.

If you submitted a Mailbox Damage Report more than 24 hours ago,
and if you have not yet been contacted, please call (608) 757-7919.

Mailbox Damage Incident

( * indicates required fields)

Incident Date & Time *

Street Address *

City/State/Zip *

Township *

Property Damage Amount *

Property Damage Description *

Name (First, MI, Last) *

Phone Number *

Email Address

Please enter your current address below only if it is different from the location of the occurrence above.

Street Address

City/State/Zip

Please enter any other information you would like us to know. If you have information on who may have damaged the mailbox, please include it here.

For security, please enter the bold letters in this box. *