Today's Date:                    Time:

Complainant's Name:

Date of Birth:

Address:

Telephone Number:

Unless a police officer is on the scene at the time a dog violation occurs and can be a direct witness to the infraction of the law, he/she cannot be a witness. Therefore, the complainant must agree to appear as a witness.

"As a complainant I understand that I must agree to appear as a witness in the event that the dog violation(s) continue after a warning letter is sent to the owner of the dog, and it becomes necessary to issue a citation to the owner. In filing this complaint, I hereby agree to appear and attend a hearing before the District Magistrate should it be necessary"

Nature of the problem

Date(s) of dog nuisance: Time of Day:

Description of Problem

Owner of Dog:

Address          

Phone:            

    Complaint History