Name:

Email:

Contact Phone Number: Please include area code

Best Time to Contact you: (Daytime, Evening)

Incident:

Cruelty to Animals in Entertainment Pet Theft Animal Fighting Factory Farming Lost Animal Hunting/Trapping General Animal Cruelty Vivisection/Labratory Cruelty

 

Date Of Occurrence:

Time of Occurrence:

 

Status of Occurrence:

Issue has Stopped Issue is Ongoing Issue is Intermittent Other

Describe if you selected "Other"  

 

Location of Occurrence:

Address:

City:

County:

State:

Country:

 

Type of Animal:

Dog Cat Horse Bird Cow Pigs Goats Aquatic Rodents Primates

Report Filed:

Yes No

What Department:

Police Sheriff ATF FBI USDA Animal Control Animal Regulation HSUS SPCA

 

Department Contact Name:

 

Department Contact Phone: Please include area code

 

Animal Identification:

Collar Tattoo Microchip Other

Describe if you selected "Other"

 

Do you have any Physical Evidence?

Video Tape Still Photographs Witnessess Other Documentation  

 

Do you have any information that this is an issue in your: 
(Neighborhood, City, Count, State)?

 

What other Animal Groups have you contacted?

 

Other Info:

        

If you experience problems with this form please call us at 310-271-6096 x 27.

 

DISCLAIMER:
LCA SIU will review all incidents reported and submitted to us through this form. LCA SIU cannot guarantee that the information submitted will be investigated. We may contact you for further information.

If you have any questions about our current Special Investigations, please contact siu@lcanimal.org or (310) 271-6096 x24.