ASB online reporting form

Use this form to report antisocial behaviour

	Housing Office *
	Title
	First name
	Last name
	Your address
	Contact telephone number
	Email *
	Who are you making the allegation about?
	Please give details of additional people involved
	I dont know who else is involved
	If you don’t know them, give a description. (e.g. a boy about 15 wearing a blue denim jacket. He was tall with red hair)
	If you don’t know them, give a description. (e.g. a boy about 15 wearing a blue denim jacket. He was tall with red hair)
	Do we have your permission to contact the people you are making the allegation about?	Yes No
	Please give details of the issue you are reporting
	Where was it happening?
	Date of first incident?
	Please select the type of nuisance :	Danger to your household and/or persons within it Domestic violence Threats of or actual violence against a person Drug dealing or any other illegal activity Intimidation or harassment on the grounds of race, disability, sexual orientation, religious belief or vulnerability Property damaged Non threatening verbal abuse Noise nuisance for example: loud parties, shouting, noise from TVs, radios, Hi-fis, burglar alarms and dogs barking Children loitering Local environmental issues. For example, litter, dog fouling, uncontrolled dogs, graffiti, vandalism, fly tipping, abandoned and untaxed vehicles, vehicle repairs inconsiderate parking, unkempt gardens, riding, cycling and skateboarding on communal areas
	Other, please specify
	Additional information
	Have you contacted anyone in Lewisham Homes about your allegation previously?	Yes No
	If yes, what was the name and job title (if known) of the person?
	On what date did you contact the person?
	What response did you receive?
	Please enter verification code as shown *

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ASB online reporting form

Use this form to report antisocial behaviour