Animal Care and Control Witness Report
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Incident
*
Time of Incident
*
Animals Present at Incident (please include Breed, Color, Name and Known Owner)
*
People Present at Incident:
*
Was this reported to a law enforcement agency?
*
Yes
No
Which agency?
*
Please describe what took place at the incident:
*
Have you been assigned an Animal Care and Control case number? If not, please leave blank.
Please attach any images or files that pertain to the incident:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: