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Litter On Street Incident Report Form -

Fields marked with an * are required for the form to be submitted.

Contact Details
?	Witness Name *
?	Address *
?	Postcode *
?	Email Address
	Telephone Number
	Name(s) of any other witness(es)
Perpetrator Details
?	Perpetrator Name *
?	Perpetrator Address *
	Gender
	Approximate Age
	or Date of Birth
	Brief description giving key details *
Incident Details
	Detailed Location of Incident *
	Date of Incident (dd/mm/yyyy) *
?	Time of Incident *
	What was the litter deposited/dropped/thrown *
?	Where was the litter deposited? *
	Was any attempt made to remove the deposit?
	Was physical evidence retained by the witness(es)?
	If physical evidence was retained, where is the current location of this evidence?
Weather and visibility details
	What was the weather like? *
	How well lit was the scene of the incident? *
	Where did you view the incident from? *
	How far were you from the incident? *
	Were there any obstructions to your view, and if so, what? *
	For how long did you watch the incident? *

	Other relevant comments
	Should the Council decide to prosecute the offender for this offence, would you be prepared to provide a witness statement or, if necessary, attend court? *