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Debra Cook, Manager

1060 AI Bishop Dr.Marietta, Ga. 3008Telephone: 770-499-4136Fax: 770-590-5620

G. B HatfieldChief of Police

A.B. AllredDeputy Chief

Affidavit of Complaint

Generally, violations of the Cobb County Ordinances donot occur when an officer is present. For an AnimalControl Officer or the Animal Control Unit to take an

action regarding a violation, either the officer or someoneelse must witness the incident( s).

This Affidavit of Complaint or statement, when completedby a witness provides the documentation necessary for anaction to be taken. It establishes probable cause for anofficer to believe that a violation. took place, who wasinvolved, and the nature of the violation. This statementform is essential for Animal Conttol to pursue furtheraction in reference to the violations you have described.For Animal Control to efficiently respond to your needs,we ask that you review and carefully complete thisstatement to the best of your knowledge, and return it to theAnimal Control Unit within 10 days.

CASE NO:--------------

TELL US ABOUT YOU!

This portion is to be completed by you, and about you. We need to knowyour full name, address, and various other information. Please print neatlyor type, and review the completed form to ensure that all information isincluded and correct.

Name:Last First: MI:---------- ---------- -----Street: ----------------------------

City: State: ......;Zip: _

Telephone:Home ( ) Work: ( )-------TELL US ABOUT THE ANIMAL O\VNER:

We need you to record as much information about the animal owner as youknow. Don't guess, be certain. If there is some information that you do notknow, simply write "unknown". The information most needed is the animalowner's address. If you are uncertain about the owner's information, or ifthe animal even has an owner, speak with your neighbors to be sure.

Name:

Last: First: MI _

Street:--------------------------City: State: Zip: _

Telephone:Home: ( ) Work: ( )---------When is the owner normally home? _

CASE NO:-----------

WHAT DOES THE ANIMAL LOOK LIKE?

To take action, Animal Control needs to be as certain as possible that we aredealing with the correct animal(s). Please record as much and as accurate a .description of each animal as possible. Only list animals that were involvedin the specific incident you are completing this statement for. Here's somebasic rules:

• Breed is for species as well as the animal's specific breed• Color: Indicate the dominant color first, then all the other colors

Breed Color Male Female Name

If you are uncertain about the animal or its description, be sure that you talkto your neighbors. Incorrect information damages everyone's credibility ifthe case were to be challenged in court.

CASE NO: _

\VHEN AND WHERE DID IT HAPPEN?

This is where you tell your story. Please fill in all blanks with EXACTtime, date, and location, based on what you observed. Without thisinformation, Animal Control cannot pursue further action. Here are someexamples:

Location: In street in front of 1212 Smith St. or

In my front yard at 2121 Jones St.

Time: 1:30 pm

Location of Incident:

Date of Incident: Exact date(AM or PM)

Time of Incident: Exact time

TELL US WHAT HAPPENED.

In this section you will write a brief story of what happened, based on theinformation you gave about When and \Vhere it happened, and what youobserved. Only write about the most recent occurrence. Previousoccurrences are not relevant. DO NOT write about hearsay or otherconflicts there have been with the animal owner. Hearsay is what you haveheard from other"people, not what you have observed, and is not admissiblein court. If you require more space, simply continue on another piece ofpaper. Please print clearly or type. Be sure to sign the form on the last page.

CONTINUED ON NEXT PAGE

CASE NO. _

\\'ITNESSES: (attach additional sheets if necessary)

Name _Address -------------------Phone no. -------------------

Name ---------------------Address --------------------Phone no. -------------------

PRINT OR TYPE YOUR FULL NAME

I swear or affrrm that the statementcontained herein is true and correct

to the best of my knowledge and belief

Signed: _

Date: __ ~~~~~~~_20 _