Attention: To : .................................................. [MP/MLA] To : .................................................. (Councillor) Vidhan Sabha : ...................................................... Ward : ................................ I am writing to you to bring your attention to the following issue(s): 1. Road damage or broken roads. 2. Electricity issues. 3. Sewage or drainage problems. 4. Water supply issues. 5. Garbage collection or sanitation. 6. Any other local issue: [Underline space to specify] Address of the issue: .............................................................................................................................. ................................................................................................................................................................................... This matter is urgent because it is causing difficulties in daily life activities for residents, including myself and my family. We kindly request you to address and resolve this issue as soon as possible so that our environment and daily routines can be peacefully restored. Name: ............................. Date: ................................ Phone Number (Optional) : +91.................................................. Signature I also give consent to Nyay Fauj and Members to submit the form, appeal, move to court if necessary on my behalf, any available actions under Constitution and Indian Law.