Please fill out the form below to file an Animal Care & Control Complaint.

You may also download a printable version of this form by clicking the “Download Form” button below.

Animal Care & Control

Complaint Report
Report #
Date

Month Day Year
Date
Reporting Party
Name

First Name Last Name
Date of Birth

Month Day Year
Date
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Animal Owner
Name

First Name Last Name
Date of Birth

Month Day Year
Date
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Incident Report

Please describe the nature of the complaint or problem, with all pertinent information including dates, time of incident(s), location of violation(s), and names and phones numbers of witnesses.
Date of Incident

Month Day Year
Date
Time of Incident
Description of animal(s) involved:
Date of Contact with Complainant

Month Day Year
Date
Contact with Complainant
"I certify under penalty of perjury under the laws of the State of Michigan that the foregoing is true and correct and that I am willing to testify to this in a court of law."
Signature

Clear
Date

Month Day Year
Date
Should be Empty:

Animal Care & Control