Pitt County Forms Center

2.  
   
   
   

   4550 County Home Rd. Greenville, NC 27858  |  Telephone: (252) 902-1725

   Dangerous Dog Investigation Request
    

4. Requesting Person's Name:*
5. Phone Number:*
7. Requester's Address:*
9. Please answer the following description questions below about the dog:
11. Sex:*
12. Breed:*
14. Color and/or Markings:*
16. Dog Owner's Name (if known):
17. Owner's Address*
19. Notice to Person Filing Dangerous Dog Complaint*

    A dangerous dog investigation is scheduled so that it can be completed within 30 days. To insure that it can be completed in a timely manner, the Rabies Control Officer will need all written statements and evidence provided to you within 10 days of today’s date. Please be aware that evidence used in this investigation will be supplied by you and the dog’s owner. The information will be submitted to the Animal Control Manager at the expiration of the 10 day period. The Animal Control Manager will base her decision upon whatever information has been supplied to her. A new complaint may have to be filed, if the information is received after the 10 day period has expired.
    A copy of the law is also provided for your information.

    1. I understand
21. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
23. Electronic Signature of Person Making Request*
24. Date*
    Date
28. The fields below are for internal office use only.
30. Signature of Person Taking Request:
31. Date:
32. Referred To:
33. Referred Date:
35. Person(s) Contacted:
36. Action Taken:
37. Signature of Rabies Control Officer:
38. Date:
Leave This Blank:


40. Submit Submit and Print

* indicates a required field