Incident Report

For this complaint to be considered valid and have your concerns addressed, it must include your name, address and email or telephone number and describe who, what, where and when the infraction occurred.

Date of Incident*

Time of Incident*

Location of Incident*

Description of Incident*

Please be as specific as possible regarding who, what, when and where. Include the name and unit # of other tenant’s involved. Please state only the facts, not assumptions, opinions and/or judgements. Point form is preferred.

Were there any witnesses besides you to this incident?*yesno

If yes, who?*

Was a police report files regarding this incident?*yesno

If yes, please provide the file #*

How did you handle the problem?*

For example did you intervene, speak with those involved, call the police? Please describe.

Your Information

First Name*

Address *

Phone*

Email*

I confirm that all information submitted in this form is true and accurate. I also understand that my name will be held in confidence unless this matter is subject to Dispute Resolution under the Residential Tenancy Act, a court action, or a police investigation.

Today's Date*