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2. Type of Complaint*
   -- Select One --Bite or aggressionNoiseLeash LawConfined Stray AnimalCrueltyAbandonmentInjuredDeceasedOther
4. Description of animal*
   -- Select One --DogCatOther
5. Sex of animal
7. Color of animal*
8. Date and/or time incident occured
   Date and/or time incident occured

   Date and/or time incident occured
10. Description of events *
12. Address where incident occured
14. City*
15. State
16. Zip
18. Pet owner name and/or address, if known
22. Your Information
24. Your First Name*
25. Your Last Name*
27. Your address*
29. City*
30. State*
31. Zip*
33. Phone Number*
34. Alternate/Cell Phone
35. Email*
37. 2. Under the Public Records Act, chapter 42.56 RCW, the information provided on a complaint investigation request form is subject to public disclosure. Information revealing the identity of persons who are witnesses to crimes or who file complaints with investigative agencies may be withheld from disclosure under RCW 42.56.240(2) only if the disclosure of such information would endanger any person’s life, physical safety, or property and if you as the complainant indicate a preference not to reveal your identifying information. Under RCW 42.56.240(2), as the complainant, the preference you indicate on this form shall govern whether such identifying information will be disclosed or withheld in response to requests for public records. It should be understood that if this case is filed in court, your name must be disclosed IF you are to be a witness in the case.

    Regardless of any request for confidentiality under the Public Records Act, you may still be called to testify or to provide other evidence in this matter.

    1. I have read the above and I do not want my identity disclosed upon public inquiries regarding this complaint without my permission.
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39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit Submit and Print

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