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"b#Address of applicant
<aytime telephone no.(incl. National dialling code) :a! no. #9$ A&) (&1-11)
"f you would li.e us to ac.nowledge receipt of this application, please tic. 5N of the following bo!es to indicate your preferred method* mail Telephone :a! $etter
$ %etails of complaint Please pro&ide a map sho'ing the location of rabbit damage and harbourage described belo'
"a# (ocation of damage Please provide full details e.g. address, field or compartment numbers
)n relation to this land are *ou+ (please tic. as appropriate) The owner "b# ,ature and e-tent of damage Please give details including* , type of crop and area damaged , cost of damage (e.g. yield loss, cost of additional fertiliser or seed) , time of year damage occurs , length of time the damage has been occurring ,whether damage is currently occurring. 4ontinue on a separate sheet as necessary Please attach any supporting documentation (e.g. yield data, agronomist8s reports, photographs) as appropriate
The Tenant
"c# .ource of rabbits Please provide details of where the rabbits causing the damage are harboured (e.g. name of land, postal address, field or compartment numbers)
"d# Are there an* other causes of damage "e g other animals/ disease/ poor germination or drainage#0 "f A 0, please give details and state what (if any) action you have ta.en.
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"f !E./ please provide details of the contact made with the neighbour(s) including dates and responses. Please provide copies of any correspondence sent and-or received.
"f you answered ,2 at +(a) above, please state why you have not made any contact with the neighbour(s). Please note+ it is unlikel* that a complaint 'ill be taken for'ard 'hen no attempt has been made to contact the neighbour to resol&e the problem
"f !E. please provide details of rabbit harbourage and of any action you have ta.en to control the rabbits harboured on your land.
.ection 7+ %eclaration
" have read and understand the guidance provided in this complaint form. " declare that the particulars given are correct to the best of my .nowledge and belief, and " ma.e a complaint in accordance with these particulars. 0ignature of complainant
For applications submitted via email, please insert an electronic signature above or tick this box to confirm agreement with this declaration Name (in ;$54D $ TT (0) <ate