Nuisance Animal Preliminary Complaint Form
Ventura County Animal Regulation Department
REPORTING PARTY INFORMATION:
Name:____________________ ____________________ Telephone:_______________ ______________ First Last Daytime Evening
Mailing Address:____________________________________ Street Address:____________________________________
City:__________________ Zip:___________ City:__________________ Zip:_____________
Animal Description(s):________________________________________________________________________
Briefly Describe Nuisance Behavior(s):___________________________________________________________ __________________________________________________________________________________________.
ADDITIONAL INFORMATION:
Animal Owner’s (A/O) Name: _________________________________Telephone:_______________________
A/O Address:___________________________________________ City: ______________________________
Have you contacted Animal Owner About Problem? Yes
No
When?:_______________________________
What Happened?___________________________________________________________________________
If no contact, WHY ?_________________________________________________________________________
Co-Complainant Name(s):______________________________
____________________________________
Print and Mail or Fax To: Ventura County Animal Regulation Department Attention: Formal Complaint Desk 600 Aviation Drive, Camarillo, CA 93010 Fax: (805) 388-4393