Executive Order Violation Report

Give residents a safe channel to flag businesses or individuals not complying with an executive order. It records incident details, date, location and supporting evidence, with an anonymous option.

Use this template

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In the Claude connectors directory

Do you want to submit anonymously?

Yes, anonymously No, I will include my details Only if necessary

Your Name

First Name

Last Name

Your Phone Number

Your Email Address

Your Address

Street Address

City

State / Province

ZIP / Postal Code

Name of the person, business or organization violating the executive order

Phone Number

Website

Address of the business, establishment or organization

Street Address

City

State / Province

ZIP / Postal Code

Date when the violation happened

Time when the violation happened

Indicate which provisions of the executive order are being violated

Exceeding capacity limits No face coverings Operating after permitted hours Non-essential business operating No social distancing Gatherings above the limit Other violation

Description of the violation

You may upload videos, audio, images or documents that support your report

Max 10 MB per file

Any additional comments