Name of complainer
Contact Number
Contact Email
Address
Pin Code
Country
Name of Accused
Contact Number
Contact Email
Address
Pin Code
Country
Animal faced abuse
Describe the abuse
Photo Evidence
Video Evidence
Any medical examiniation done?
If Yes upload the the report
Rate the pain animal might have endured during the abuse (1 - Extremly low, 5 - Highest Extrem )
Signature