Animal Nuisance investigation application form

ANIMAL NUISANCE INVESTIGATION REQUEST

APPLICATION FORM

To enable Council to investigate animal nuisance complaints, this form needs to be completed and returned to Council. The information provided will not only assist Council in addressing the complaint, but may form the basis of evidence required in the event that the matter is taken to court. Should you require any further information on this matter, please contact Council's Environmental Health Officers on 9911 6555 Mon-Fri 8.30am-10:30am.

Complainant Details

Surname *

First Name *

Address *

Postcode *

Phone (m): *

Phone (h):

Phone (w):

Email *

Details of Animal Nuisance

What is the source and nature of the nuisance? *e.g. Poultry, odour

What address is/are the animal/s located at? *e.g. Property address, landmark etc

Where is/are the animal/s kept at this location *e.g. Backyard

How have you confirmed that the nuisance being experienced is from the identified animal/s? *

How long has this nuisance been occurring? *

How is/are the animal/s affecting you? *

Have you spoken to the person responsible for the animal/s? If yes, what was the outcome? * If no, it's recommended that you address the matter with the person responsible for the animal/s prior to making a complaint to Council.

Please provide any other relevant information:

What would you like to see happen in resolving this complaint? *

Do you give permission for Council to forward your complaint and contact details to other authorities (e.g. NSW DECC) where Council is not the appropriate authority? *

Yes No

Are you aware that if this matter goes to court, you may be required to give evidence? *

Yes No

Please add any additional comments:

Declaration

I declare that all the information provided above is true to the best of my knowledge. Please return this form toCouncil using the details below. Please be aware that should you fail to return this form, Council may notinvestigate your complaint any further.

Applicant Signature *

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Date signed *