This form is intended to aid you in receiving information from Lincoln County Animal Services that is subject to North Carolina public records laws. Please allow sufficient time for us to process your request and for you to receive the information. Pursuant to applicable North Carolina General Statutes, this document may be considered a public record; as such it may be subject to inspection.

Contact Information

Full Name:*

Email Address:*

Address:

City:

State:

Zip Code:

Telephone Number:*

Fax Number:

Requested Records/Information (please be as specific and detailed as possible):*

Details of Incident (please be as specific and detailed as possible):*

Date Incident Occurred:

* How would you prefer to receive the requested information?*

Email Faxed

Mailed Other

If other, please specify:

Complete the following sections only if they pertain to the information you are requesting:

Victim's Name and Address:

Name and Address of Owner/Keeper of Animal: