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Calaveras County Department of Animal Services

Complaint Form

To allow us to resolve your concerns while providing a safe and healthy community, please provide as much information as possible on this form.

If you prefer to print, complete and fax or submit the form in person, please use the form located on our website at https://animal.calaverasgov.us/Forms

Reporting Party

NOTE: Your contact information is required in order to submit a complaint. (This information will be kept confidential)

Your Name:

Your Address:

City:

Zip Code:

Your Phone:

Your E-Mail:

Owner of Offending Animal
(if known)

NOTE: Address and Brief Description of location are required.

Name:

Address:

Brief Description of Location (cross streets, color of house, etc):

City:

Zip Code:

Phone:

Email:

Facts and Circumstances

Date of Incident:

Time of Incident:

Location of Incident:

Type of animal(s):

Describe Animal(s) Briefly:

Please provide the nature of the complaint:

999 Character Maximum:

Signature

When submitting an online form, typing your name below is equivalent to a signature.

Signature:

Date: