animalnuisances

Complainant Record of Offense
Section 110. Responsiblilities of Offended Persons. It shall be the responsibility of the persons being offended to record the date and times of the offense along with the location of the offending animal, and owner, if possible. This record shall be verified and and dated by the complainant and provided to the Police Department prior to issuing a notice of violation under Section 111 of this part. Should it become necessary, the complainant shall appear at the district justice hearing as a witness for the Township.

Complainant: Please provide a written statement of the offense. Be sure to include dates, times, the location of the offending animal and the type of offense, animal and the owner, if possible.

Name

Address

Phone

By checking this box you verify that you are the person filling out this form and that the information you have provided is true to the best of your knowledge. You further acknowledge that you may be called upon as a witness for the Township should this complaint go to the District Justice.

Date

Officer: This information must be completed, verified and dated prior to serving written notice to the animal owner. Both original copies of the written notice and this complaint form will be kept on file at the Amity Township Police Department.

Officer Name and Badge Number