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ANIMAL CRUELTY REPORT FORM

If this is an emergency, please call 911!  During regular working hours, you can also call 831-373-2631 or 422-4721 x213.

Please fill out this form if you witness any potential case of animal neglect or cruelty. Any information you are able to provide below will help us investigate your complaint. All reports are considered completely confidential and will not be shared with individuals outside of law enforcement without your permission. We ask for your contact information at the end of this report in the event we need additional information; however you may remain anonymous if you choose. Based on the information you provide, we will investigate your complaint to ensure that the animal or animals are being treated humanely.

Although no fields are required in this complaint form, please fill in as much information as possible to help us investigate your complaint. If you have any questions, please contact us at 831-373-2631 or 422-4721 x213.

ANIMAL DESCRIPTION
What type of animal is it?
Dog Puppy
Cat Kitten
Horse Mule/Burro
Goat Sheep
Cow Rabbit
Bird Chicken/Rooster
Reptile Fish
Wildlife Other
   
How many animals?
     
What size is the animal? Small
  Medium
  Large
   
Breed if known:
   
What color is the animal?
 
 
PLEASE DESCRIBE THE CONDITION OF THE ANIMAL:
Housing/Shelter: None
  Inadequate
     
Confinement: Chain or tether
  Small Pen or Cage
  Entangled
  Running at Large
  Other
     
Water: None
  Inadequate
  Dirty
     
Food: None
  Inadequate (type or amount)
  Spoiled
     
Sanitation: Feces/Urine
  Weeds
  Flies
  Trash
  Wet or Muddy
  Hazards
     
Skin/Coat Condition: Hair Loss
  Mange
  Sores
  Excessive fleas/ticks
  Excessive mats
  Other
     
Physical Condition: Thin
   

Ribs Showing
   

Backbone Showing
   

Hip Bones Showing
     
  Injured
    Shot
    Stabbed
    Cut
    Beaten
    Bleeding
    Limping and/or Fractures
    Overheated
    Collar embedded
    Eye and or Ear Infections
    Unable to stand
    Other Injury
     
Where is the animal injured? Head
  Back
  Legs
  Rear
  Tail
 
 
WHO DO YOU THINK MIGHT BE RESPONSIBLE?
Name:  (if known)
     
Physical Description:
(check all that apply)		 Adult Male
  Adult Female
  Juvenile Male
  Juvenile Female
     
    Race:
    Caucasian
    African American
    Hispanic
    Asian
    Other
     
    Approximate Height:
    Ft. In.
     
    Approximate Weight:
    Ibs.
     
    Hair Color:
    Black
    Brown
    Blonde
    Red
    Grey
     
    Facial Hair:
    Mustache
    Beard
   
Home Address:   Number, Street
   Apt. Number
    City
  State
  Zip
   
Home Phone:   (     ) ____-______
Cell Phone:   (     ) ____-______
   
Work Address:   Company Name:
    Number, Street
   Suite Number
    City
  State
  Zip
   
Work Phone:   (     ) ____-______
     
Vehicle Type:
(if any vehicle was associated with the animal or the person responsible)		 Car
  Truck
  Van
  Motorcycle
     
  Color:
  Make & Model:
  License Plate:
  State:
 
 
WHERE DID THE INCIDENT OCCUR?
Address:   Number, Street
   Apt. Number
    City
  State
  Zip
 
If exact address is not known, please describe location:
 
 
Where is the animal currently located?
 
 
 
YOUR INFORMATION:
If this is an emergency, please call 911!  During regular working hours, you can also call 831-373-2631 or 422-4721 x213.

Please note that all calls are completely confidential and no personal information is passed on to third parties outside of law enforcement without your permission. If possible, please share your contact information with us so we can contact you for additional details, if needed.
   
Your Name:
   
Your Address:   Number, Street
   Apt. Number
    City
  State
  Zip
   
Your Home Phone:   (     ) ____-______
Your Work Phone:   (     ) ____-______
Your Cell Phone:   (     ) ____-______
   
Your Email Address:
 
 
ADDITIONAL INFORMATION YOU WOULD LIKE TO SHARE:
 
 
IF YOU WISH TO REMAIN ANONYMOUS, PLEASE CHECK THIS BOX - 
   
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