Bedford Highways Fault Reporting Form

EF1012

This form should be used to report non emergency highway faults, e.g. potholes or street lighting problems. If you believe the fault you are reporting is an emergency (e.g. likely to cause damage or injury or wires showing) then please telephone the 24 hour phone line (01234 228661) to report the fault.

All fields marked with a '*' are mandatory fields

Your details:

Please provide contact details so that, if necessary, we can contact you.

Title
Surname
Forename
Home Telephone Number
Mobile Telephone Number
Email Address

House Number

Postcode

Data Protection Act 1998

Please note that the personal details supplied on this form will be held on a file and/or computerised by Bedford Borough Council. Your personal details may be shared internally within the Council, but will be safeguarded and will not be divulged to any other individuals or organisations for any other purposes.

Type of fault ^*

Pothole

Street light

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Bedford Highways Fault Reporting Form

Data Protection Act 1998