Incident Report Form

* Indicates required field

Address where the incident happened: *

Time of the incident: *

Location of the incident: *

Name: *

Please enter your first and last name.

Phone Number: *

Description of the incident: *

What do you expect to happen as a result of your complaint? *

Nature of incident:

Physical Violence

Safety

Neighbour Dispute

Noise Complaint

Pet Issue

Damage/Theft

Are you willing to be a witness at the Landlord and Tenant Board, if required?

Yes

Police called?

Yes

If you called the police, what was the officer's name?

If you called the police, what was the police occurrence number?

What happened to this complaint? Your complaint will be reviewed and incidents will be investigated. If further incidents occur, please continue to submit new complaint forms with the additional information. You may be contacted for clarification regarding your complaint (s) or asked to be a witness at the Landlord and Tenant Board, although this is not always necessary. You may not be contacted or informed of action being taken by WECHC, due to privacy legislation. This does not mean action has not been taken.

Completed by: *

Please enter the first and last name of the person completing this form.

Signature: *

Sign above

Date completed: *

Upload any relevant documents:

One file only.
64 MB limit.
Allowed types: jpg, jpeg, png, txt, rtf, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, odg, odp, ods, odt, fodt, fods, fodp, fodg, key, numbers, pages.

Please utilize this space to upload any documents that are relevant to this incident (i.e. pictures, evidence).