Anti-social Behaviour (ASB) Case Review Online Reporting Form

Your contact details

* Phone number

* Address

* Telephone

Email address

* Please confirm your preferred contact method to discuss your case

Incident details

* Can you confirm the incidents you have reported relate to anti-social behaviour Mandatory - Can you confirm the incidents you have reported relate to anti-social behaviour

* Have you reported these incidents three times within the last six months to either the Police, Solihull Community Housing and/or your social housing landlord

Please note: you will need to have reported three separate incidents of ASB within the last sixth months for a trigger review to be undertaken.

* Do you think that the incidents are because of ethnicity, religion/faith, disability, sexual orientation or being transgender

What happened

Please provide in the boxes below, the following information based upon any reports that you have made to the Police, Solihull Community Housing and/or your social housing landlord within the last six months that you remain dissatisfied with the agency response or the outcome of your case:

Date of the first incident of ASB and the date you first reported it to the agency/ies and the details of any subsequent incidents and the dates you reported them
What happened, please provide a brief overview of the ASB incident (The trigger panel cannot investigate criminal matters. These must be reported to the police for them to investigate)
Who was the person committing the ASB (Please provide names and addresses)
Were any other people involved in the incidents of ASB (Provide their names and addresses and explain how they were involved)
Which agency you reported the ASB to (e.g. Solihull Council, Police, Solihull Community Housing and/or another social housing provider). If you know your case reference number that, you were given (e.g. Crime Reference Numbers and Case Numbers) please add this too
Outcome/action taken by Police, Solihull Community Housing and/or your social housing landlord
Why you are dissatisfied with the action taken by the Police, Solihull Community Housing and/ or your social housing landlord

* Reported Incident 1

* Reported Incident 2

* Reported Incident 3

If you have made more than three reports within the last six months to the Police, Solihull Community Housing and/or your social landlord, please provide details in the space provided below and by following the format above.

Did anybody else witness the above listed anti-social behaviour or is anybody else affected. Please only give the details of those affected if they are willing to be contacted as part of the trigger review process. The panel will seek their consent to be involved in the review

Name(s)

Contact telephone number(s)

Address(es)

Further information

Which of the following describes you

If you are renting your property, please provide the following information:

Your managing agents name

The name of the person at the agents who you have contacted about the ASB

The managing agent’s business address

The managing agent’s telephone

The managing agent’s email

About you - equalities monitoring

Gender

Age

Sexual orientation

Religion

Ethnicity

Can you please provide details of any disability

Once your form has been submitted it will be shared with Council departments, the Police, Solihull Community Housing and any other social housing providers linked to your case. If your case requires it, we will share this information with other partner agencies linked to the Safer Solihull Partnership and others that can help to address ASB.

* Do you consent to share your information

Once we have received, all the information above we will contact you to advise you of the next stage of the trigger review process. In the meantime, please do not hesitate to contact us at safersolihull@solihull.gov.uk or call us on 0121 704 6867 if you have any further questions.

Data Protection

Your information may be shared with other council services and partner organisations to ensure our records are kept accurate and to help us to identify services or benefits you may be entitled to or interested in. We may also need to share your information for the prevention and detection of fraud and/or other crimes or as the law requires. For further information about how we use your information please refer to the Council’s Privacy Statement on www.solihull.gov.uk.