Anti Social Behaviour Form

Title (required)

First Name(s) (required)

Last Name

Address

Postcode

Preferred contact details (please give phone number or email address)

Name(s) of people or persons causing the problem(s)

Address of people/person

Nature of complaint i.e. noise / graffiti / abusive / behaviour / control of pets / parking / litter etc. Please detail exactly what happened and what you saw or heard.

Have you contacted another agency?
YesNo

If yes, please state which agency you have contacted i.e. Police / Social Services / Environmental Services / Dog Wardens etc...

Police Incident Number (if applicable)

What time and date did the incident occur?

Do you have any specific communication needs we need to be aware of?
NoYes

If yes, please state your requirements:

Do you require communication to be provided in an alternative format (e.g. British Sign Language, different language, large print, Braille or audio CD)?

By providing the above information, you consent to Greenfields processing your data to enable us to effectively deal with the issues you have reported. You are able to withdraw your consent at any time by contacting your Neighbourhood Co-ordinator. However, please note that we are required to retain the information relating to this reported issue for as long as the affected tenancies remain active and six years after a tenancy has ended as per our Data Retention Schedule. For further information please see Our Privacy Policy or our Anti-social behaviour policy, found in the Supporting Documents panel on the right.

I confirm that I understand how the data submitted will be used.
I give my consent for my information to be processed as stated above