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2. Citizen Input Form
4. Name:
6. Address:
8. Email Address:*
   Email address is required.
10. Daytime Phone Number:
12. Questions/Comments/Concerns/Complaints (500 words or less)
14. This form will be submitted to the Mayor's Office at the City of Dothan. Thank you for your input.
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16. 1. Receive an email copy of this form.
17. Email address

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18. Submit

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