Skip to Main Content
Loading
Loading
Government
Services
Community
Business
I Want To...
Home
Form Center
Form Center
Search Forms:
Search Forms
Select a Category
All Categories
Administration
Contact Us
Online Bidding Forms
By
signing in or creating an account
, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Dangerous or Vicious Animal Report Form
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Assumption Parish Police Jury
To the Assumption Parish Police Jury:
The undersigned of the Parish of Assumption does hereby file complaint that the property owner stated below is in violation of the Assumption Parish dangerous, vicious and fierce animal ordinance (00-16).
Date
*
Date
Enter the date
First Name
*
Enter your first name
Last Name
*
Enter your last name
Address
Enter your address
City
Enter your city
Zip Code
Enter your zip code
Email Address
*
Enter your email address
Phone Number
Enter your phone number
Property Owners Name
Enter the name of property owner that owns animal if applicable
Address to Property in Violation
*
Enter address of property or nearest address to where animal is located
City
*
Enter city of property in violation
Zip Code
Enter zip code of property in violation
Description of Dangerous, Vicious or Fierce Animal
*
Enter a description of the dangerous, vicious or fierce animal
Electronic Signature Agreement
*
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
I agree.
Electronic Signature
*
Leave This Blank:
Receive an email copy of this form.
Email address
This field is not part of the form submission.
Submit
* indicates a required field
Arrow Left
Arrow Right
[]
Slideshow Left Arrow
Slideshow Right Arrow