Reporting Party Information First Name* Last Name* Address Line 1* Address Line 2 City* State* --Select-- OUT OF COUNTRY ALASKA ALABAMA ARKANSAS ARIZONA CALIFORNIA COLORADO CONNECTICUT DISTRICT OF COLUMBIA DELAWARE FLORIDA GEORGIA GUAM HAWAII IOWA IDAHO ILLINOIS INDIANA KANSAS KENTUCKY LOUISIANA MASSACHUSETTS MARYLAND MAINE MICHIGAN MINNESOTA MISSOURI MISSISSIPPI MONTANA NORTH CAROLINA NORTH DAKOTA NEBRASKA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEVADA NEW YORK OHIO OKLAHOMA OREGON PENNSYLVANIA PUERTO RICO PALAU RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VIRGINIA VIRGIN ISLANDS VERMONT WASHINGTON WISCONSIN WEST VIRGINIA WYOMING ZIP Mobile Phone* Daytime Phone Email Address* Owner of Animals, if Known Owner First Name Owner Last Name Incident Details Incident Address Line 1 Incident Address Line 2 Incident City* Incident State* KENTUCKY Incident ZIP Incident Location Notes/Description Type of Premises --Select-- Residence Open Field Private Farm Boarding Facility Event Grounds Stockyard/Auction Other Type of Incident --Select-- Neglect Abuse Carcass Theft Other Species Info --Select-- Cattle Horses Sheep Goats Pigs Deer Llama Alpaca Poultry Other Number of Animals --Select-- 0-1 2-10 11-50 51+ County* --Select-- ADAIR ALLEN ANDERSON BALLARD BARREN BATH BELL BOONE BOURBON BOYD BOYLE BRACKEN BREATHITT BRECKINRIDGE BULLITT BUTLER CALDWELL CALLOWAY CAMPBELL CARLISLE CARROLL CARTER CASEY CHRISTIAN CLARK CLAY CLINTON CRITTENDEN CUMBERLAND DAVIESS EDMONSON ELLIOTT ESTILL FAYETTE FLEMING FLOYD FRANKLIN FULTON GALLATIN GARRARD GRANT GRAVES GRAYSON GREEN GREENUP HANCOCK HARDIN HARLAN HARRISON HART HENDERSON HENRY HICKMAN HOPKINS JACKSON JEFFERSON JESSAMINE JOHNSON KENTON KNOTT KNOX LARUE LAUREL LAWRENCE LEE LESLIE LETCHER LEWIS LINCOLN LIVINGSTON LOGAN LYON MADISON MAGOFFIN MARION MARSHALL MARTIN MASON MCCRACKEN MCCREARY MCLEAN MEADE MENIFEE MERCER METCALFE MONROE MONTGOMERY MORGAN MUHLENBERG NELSON NICHOLAS OHIO OLDHAM OWEN OWSLEY PENDLETON PERRY PIKE POWELL PULASKI ROBERTSON ROCKCASTLE ROWAN RUSSELL SCOTT SHELBY SIMPSON SPENCER TAYLOR TODD TRIGG TRIMBLE UNION WARREN WASHINGTON WAYNE WEBSTER WHITLEY WOLFE WOODFORD OUT-OF-STATE Incident Date:* Prior Incident Date: Feed Available Water Available Check if Local Authorities Have Been Contacted Complaint Description* Upload Images (Max Images: 10; Max Total Size: 40MB)