GEORGIA EQUINE DIVISION - EQUINE COMPLAINT FORM

Enter the following information about the Location where the problem is occurring:

        Owner's Name (if known):     Phone: Date Reported:      Time Reported:
        Street Address (where horse is located):

        City:    State:    Zip Code:    County:

Driving Directions to Site:
Type of Complaint:         Starving        Down         Dead         Injured        Other (details: )
     (If horse is "Running Loose", please contact your local Law Enforcement office.)

Additional Information

        Have you seen these horses? Yes  No       If yes, when was the last time?

        How many horses on the property?      How many affected?

        Can you see Rib/Bone structure? Yes  No

        Is there Grass? Yes  No                   Can you see all the property? Yes  No

        Is there Hay? Yes  No                      Is there a barn on the property? Yes  No

        Is there Water? Yes  No                   Do the owners live on the property? Yes  No

        Is there Grain? Yes  No

Enter the following information about yourself (optional)
        Submitters Name:     Submitters Phone: