Online application

Contact form for an urban hotline

All fields marked with an asterisk (*) are mandatory fields

Contact details

Last Name *

First Name *

City of residence *

Street *

House number *

Apartment number

Means of communication

Primary phone number *

Phone at work

Another phone

Email address *

Appeal Details

Street *

House Number *

Drag a file here או Upload a file Up to 100 megabytes jpg, png

Appeal Description *

216.73.216.109

Contact the city center

Call center 106

Contact the city center

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