Report Unlicensed Activity Form Please fill out the online form below. If you prefer to print the form and mail it to us, please Click Here. Name of Unlicensed Contractor Name of Unlicensed Company Address City State ZIP Code Telephone Your Name (Not required) Your Address City County State ZIP Code Telephone Number to Reach You (Not required) Date Work Performed Please explain the entire circumstances surrounding regarding unlicensed activity. Please include any pictures, signed contracts, cancelled checks, etc. if possible. Please attach supporting documentation (pictures, signed contracts, etc.) here
