THIS IS A BRIEF EXAMPLE OF THE REQUIRED DOCUMENTATION.
PLEASE COMPLETE IN AS MUCH DETAIL AS POSSIBLE.
RECORD OF DISTURBANCE
COMPLAINANT
NAME: _____________________
ADDRESS: ___________________
POSTAL CODE: ______________
RES PHONE: _________________
BUS PHONE: _________________
SAMPLE ONLY
SOURCE OF DISTURBANCE:
DOG OWNER: _________________
ADDRESS: ____________________
DESCRIPTION OF DOG (S)_________________________
________________________________________________
________________________________________________
DATE
FROM-TIME-TO
Jan 2/94
Jan 2/94
7:30am-9:00am
10:00am – 10:10am
Jan 2/94
Jan 2/94
Jan 3/94
Noon-1:00pm
4-5:00pm
1:00 am-2:15am
POSSIBLE REASON
FOR BARKING
None
Mailman
COMMENTS
SAMPLE ONLY
NOTE: RECORD OF DISTURBANCE SHEETS ATTACHED ARE FOR USE BY YOURSELF
SEPARATE SHEETS TO BE USED BY NEIGHBORS, IF NECESSARY FOR FURTHER
DOCUMENTATION.
NOTE: PLEASE BE AWARE THAT IF MORE THAN ONE PERSON
DOCUMENTS ON THE FORM, ALL PARTIES ARE REQUIRED TO
SIGN THE FORM AND BE WILLING TO APPEAR IN COURT.
ALBERTA ANIMAL SERVICES
RECORD OF DISTURBANCE
NAME: _______________________________________
ADDRESS: ____________________________________
POSTAL CODE: ________________________________
RES PHONE: __________________________________
BUS PHONE: __________________________________
SOURCE OF DISTURBANCE:
NAME OF DOG OWNER: ________________________
ADDRESS: ____________________________________
DESCRIPTION OF DOG (S) _________________________________________
_________________________________________________________________
_________________________________________________________________
DATE
FROM-TIME-TOTIME
POSSIBLE REASON
FOR BARKING
COMMENTS
SIGNED: _____________________________DATE: ________________________SHEET#___OF___
THIS FORM MUST BE RETURNED TO ALBERTA ANIMAL SERVICES WITHIN 14 DAYS OF
DATE RECEIVED.
ALBERTA ANIMAL SERVICES
RECORD OF DISTURBANCE
DATE
FROM-TIME-TOTIME
POSSIBLE REASON
FOR BARKING
COMMENTS
SIGNED: ______________________________DATE: ________________________SHEET#___OF___
THIS FORM MUST BE RETURNED TO ALBERTA ANIMAL SERVICES WITHIN 14 DAYS OF
DATE RECEIVED.
ALBERTA ANIMAL SERVICES
4640 61 Street
Phone 403-347-2388
Toll Free 1-866-340-2388
Red Deer, Alta. T4N 2R2
QUESTIONS TO BE ASKED RELATIVE TO BARKING DOG COMPLAINTS
1) Type of Residence:
Single Dwelling
Duplex
Condominium /Apartment
Basement Suite
2) How many dogs are being complained about? _____________________________________
3) What breed or approximate breed is/are the dog(s)?
a) _______________________________________
b) _______________________________________
c) _______________________________________
4) What color is/are the dog(s)?
a) ______________ ______________ ____________
b) _______________ ______________ ____________
c) _____________ ______________ _____________
5) When does the barking nuisance specifically occur? (Be specific – Dogs DO NOT bark all day and night)
Time(s) of day __________________________ Day of week ____________________________________
Weekends ______________________________
6) Where on the offending dog’s property is/are the dog(s) located?
____________________________________________________________________________________________
____________________________________________________________________________________________
7) Can you observe the dog(s) barking?
Yes
No
8) Can you identify the offending dog(s)?
Yes
No
9) Can you identify the owner of the offending dog(s)?
Yes
No
10) Does the dog(s) bark when the owner is home?
Yes
No
11) Does the dog(s) bark when the owner is away?
Yes
No
12) Is the dog(s) outside when the owner is away?
Yes
No
13) When is the owner usually away?
_______________________________
14) Have you discussed this with the dog owner?
Yes
No
Result of discussion (if any)
___________________________________________________________________________________
___________________________________________________________________________________
If not, why not? ________________________________________________________________
15) Are you prepared to testify in Court?
16) How long has the dog resided at the address?
Yes
No
______________ Years ___________
Months
OFFICE USE ONLY
To be proceeded with via form letter to complainant ___________________________ to dog owner _____________________
Package sent to complainant – date _________________________________________________________________________
Package sent to dog owner – date __________________________________________________________________________
Complaint to be investigated; license follow-up _______________________________ (a) (v) charges ___________________