COMMONWEALTH OF MASSACHUSETTS

COUNTY OF HAMPSHIRE

COMPLAINT OF VICIOUS OR BARKING DOG

Section 157, Chapter 140, General Laws

DATE:

I hereby make complaint that a dog or dogs owned or harbored by:

Name Address

Residing in my vicinity on or near

is a nuisance by reason of

1. VICIOUS DISPOSITION (state facts):

2. EXCESSIVE BARKING (state facts):

__________________________________________________________________

3. OTHER DISTURBANCE (state facts):

4. SOURCE OF ANNOYANCE TO A SICK PERSON RESIDING IN THE VICINITY (state facts):

This complaint is made under penalties of perjury.

Complaintant’s Signature: Phone: ______________

Print Name:

Address: