Request an anti-social behaviour review

Are you activating the trigger on behalf of someone else?
YesNo

Do you have their permission to do so?
YesNo
If not, why not?
Your name

First

Last
Your address
Your postcode
Your telephone number
Your relationship to the victim

Please select if:
You, as an individual, have complained about three separate incidents within the last six monthsFive people in the local community have complained about the same or similar incidents within the last six monthsYou, as an individual, have complained about an incident motivated by hate (hate incident/hate crime) within the last six months

Complainant details
Name

First

Last
Address
Address line 2
Town
Postcode
Daytime telephone number
Email address
Incidents
Please provide information for each of the three incidents of antisocial behaviour you have experienced. Please provide as much detail as possible.
First incident
Date the incident happened
Who did you report it to?
Details of the incident
What response did you receive from the agency you reported to about the incident?
Second incident
Date the incident happened
Who did you report it to?
Details of the incident
What response did you receive from the agency you reported to about the incident?
Third incident
Date the incident happened
Who did you report it to?
Details of the incident
What response did you receive from the agency you reported to about the incident?
Have you supplied all the relevant information
Yes

Local community complaint
Please give the following information for each of the five complaints.
First complaint and main contact
Name

First

Last
Address
Address line 2
Town
Postcode
Daytime telephone number
Email
Date incident happened:
Who did you report it to?
Details of the incident
What response did you receive from the agency you reported to about the incident?
Second complaint
Name

First

Last
Address
Address line 2
Town
Postcode
Daytime telephone number
Email
Date incident happened:
Who did you report it to?
Details of the incident
What response did you receive from the agency you reported to about the incident?
Third complaint
Name

First

Last
Address
Address line 2
Town
Postcode
Daytime telephone number
Email
Date incident happened:
Who did you report the incident to?
Details of the incident
What response did you receive from the agency you reported to about the incident?
Fourth complaint
Name

First

Last
Address
Address line 2
Town
Postcode
Daytime telephone number
Email
Date incident happened:
Who did you report the incident to?
Details of the incident
What response did you receive from the agency you reported to about the incident?
Fifth complaint
Name

First

Last
Address
Address line 2
Town
Postcode
Daytime telephone number
Email
Date incident happened:
Who did you report the incident to?
Details of the incident
What response did you receive from the agency you reported to about the incident?
Have you supplied all the relevant information
Yes

Complainant details
Name

First

Last
Address
Address line 2
Town
Postcode
Daytime telephone number
Email
Date incident happened:
Who did you report it to?
Details of the incident
What response did you receive from the agency you reported to about the incident?

Email receipt
If you would like to receive an email receipt, please enter your email address.
Email

Equality monitoring
As part of the Community Trigger, Blackpool Council is keen to ensure that all of the community are fully represented and have equal access to the process. In order to do this, we are asking those who use the Community Trigger fill out an equality monitoring form. This will give Blackpool Council a better understanding of who is accessing the process.
The data you provide here will be completely anonymised in line with Blackpool Council’s equal opportunities policy and, once submitted, will be kept completely separate from the personal details provided within your Community Trigger application. Your data will be used solely for statistical purposes.
Please note that this form is optional and you can skip this step, however your input would be greatly appreciated.
Are you
MaleFemalePrefer not to say
Do you have a disability? (A physical or mental impairment that has a substantial and long-term effect on your ability to carry out normal day-to-day activities):
YesNo
Please tell us about it
Are you?
BisexualHeterosexualGay/LesbianPrefer not to say
Are you?
ChristianJewishSikhBuddhistHinduMuslimNo religionPrefer not to sayOther
If other, please specify
Ethnicity
White
White BritishWhite Irish
Any other white background
Black or Black British
AfricanCaribbean
Any other black background
Asian or Asian British
IndianPakistaniBangladeshi
Any other Asian background
Mixed
White and Black CaribbeanWhite and Black AfricanWhite and Asian
Any other mixed background
Chinese, Traveller or other ethnic group
ChineseGypsy or Traveller
Any other ethnic group
Are you an asylum seeker or refugee?
YesNo

Request an antisocial behaviour review

Additional information