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Your Information
Please provide your information so that we can follow up with you should we need more information
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Preferred method of Contact:
*
Phone
Email
Text
Location of Alleged Dog Breeding
Please note that any reported activity outside of Philadelphia is not within ACCT Philly's power to look into.
Address where alleged activity is occurring:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How do you know this address?
*
I visited the property
I live nearby
I purchased/adopted an animal there
I witnessed activity there
Other
Description of the Complaint
What type of activity are you reporting?
*
Puppies being sold
Dogs being bred
"Puppies for Sale" signs
Multiple litters/ongoing breeding
Other
Please describe what you personally observed:
*
When did you observe this activity?
*
Approximately how many animals or puppies were involved?
*
Did you purchase or attempt to purchase a puppy?
no
yes
Please check what, if any, material you are uploading supporting your concern
*
Photos
Videos
Screenshots of social media posts
Text messages/emails
Receipt/payment records
Other
Please attach any supporting photos, screenshots, advertisements, social media posts, or other relevant information.
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Additional Information
Have you previously reported this address or individual to ACCT Philly
*
Yes
No
Unsure
If yes, approximately when and how?
Do you believe the litter was accidental or intentional breeding?
*
Intentional breeding
Accidental litter
Unsure
Signature
*
Today's Date:
*
-
Year
-
Month
Day
4 digit year, 2 digit month, 2 digit day
Date
Submit
Submit
Should be Empty: