Request an Anti-social Behaviour Case Review

Community Trigger Threshold:
- Three incidents of ASB reported within the last 6 months where the victim considers no action has been taken.
- One incident of Hate Crime nature reported in the last 6 months where the victim considers no action has been taken.
Community Trigger Online Reporting Form
1. Date Reported:*
2. 1. Have you reported this issue before? (Please specify as much detail as possible including Crime Reference number)*
  2. Label*
3. Can you confirm that the incidents you have reported are in relation to
  
  Yes - Anti-social behaviour
4. Do you think the incidents/concerns are because of
  
  Ethnicity
  
  Religion or Faith
  
  Disability
  
  Sexual orientation
  
  Being transgender
  
  None of the above
5. Who have you reported this issue to
  
  Police
  
  Environmental Health
  
  Social Services
  
  CMHT
  
  Voluntary Agencies
  
  Community Safety
  
  School
  
  GP
  
  Other (please specify below)
6. Other
7. Does this issue affect more than one household or business premises?*
  1. Label*
8. Please specify where these incidents have happened*
  1. Label*
9. Please specify who was involved in the incident/problem*
  1. Label*
10. Please specify what has happened*
  1. Label*
11. Has anyone else witnessed this?*
  1. Label*
12. How are the incidents affecting you?*
  1. Label*
13. Can you confirm that (as far as you know) no action has been taken?**
  
  Yes
14. If action has been taken please tick the correct box below
  
  Verbal Warning
  
  Written Warning
  
  Mediation
  
  Acceptable Behaviour Contract
  
  Good Neighbourhood Agreement
  
  Notice of Seeking Possession
  
  Notice to Quit
  
  Possession Order
  
  Injunction
  
  Other (Please specify below)
15. Other Action
Your Contact Details:
1. Please provide your details so that we can contact you. If you are completing this form on behalf of a friend/relative/client of your service, please provide details of the person affected by the situation. We will use this to ask you any further questions or provide feedback on your referral if necessary.
2. Name*
3. Address*
4. Address*
5. Address*
6. Address
7. Postcode*
8. Home Phone Number*
9. Mobile Phone Number
10. eMail Address
Please provide your landlords name or the name of your contact officer
1. Landlords Name*
2. Landlords Address (including postcode)*
3. Landlords contact number*
Please provide details of your Managing Agent
1. Managing Agents Name*
2. Managing Agents Address (including postcode)*
3. Managing Agents Contact Number*
Equalities Monitoring (Optional Questions)
1. Gender
  
  Male
  
  Female
  
  Transgender
2. Age
  
  8 - 15
  
  16 - 25
  
  26 - 35
  
  36 - 45
  
  46 - 55
  
  56 - 65
  
  66 and over
3. Sexual Orientation
  
  Heterosexual
  
  Homosexual
  
  Bisexual
  
  Other - Please state below
4. Other
5. Religion - Please State
6. Please give details of any disability
7. Ethnicity
  
  White
  
  Mixed
  
  Asian or Asian British
  
  Black or Black British
  
  Chinese or Other Ethnic Group
  
  Prefer not to say
9. If you would like to find out more about how Basildon Borough Council use your personal data please go to www.basildon.gov.uk/privacy
Keeping you informed
We will keep you informed about the progress of your referral.

Our promise is to acknowledge receipt of your referral immediately.

An initial assessment of your referral will be carried out in 3 working days and you will be contacted.

If your referral meets the criteria an officer from an appropriate lead agency will review your situation and agree the appropriate actions within 28 days.

This website uses cookies

Request an Anti-social Behaviour Case Review