What type of animal/s are you providing information about:
Dog
Cat
Other:
Have you visited the breeder’s property?
Yes
No
How did you learn about the breeder?
Please list all addresses you know of where the breeder keeps animals:
Please provide a description of the properties if known? (eg. rural farm, shop front, residence, etc)
Please provide business name/s the breeder trades under:
Please provide the persons name/s who runs the breeding operation/s:
Please provide details if the breeder is registered with an applicable organisation such as a dog or cat club or association? If yes, please tell us the name of the organisation/s
If you know where the breeder sells or advertises the animals e.g. Pet Shops, Online, Markets, Ships Overseas, Direct to the Public, please list them here:
Please provide any known contact phone number/s for the breeder and/or for purchasing an animal:
Please provide details for any known associates connected with the breeder:
Please describe any known vehicles the breeder drives (including registration if known):
Are they potentially violent or dangerous?
Yes
No
If yes please provide further detail e.g. firearms, violent episodes:
Are you happy for an RSPCA Inspector to contact you for further information?
Yes
No
If Yes, please provide your contact details [Name, phone number/s, email, address]:
If you would like to receive RSPCA Victoria animal welfare updates please provide your email address:
If you have any images or documents you would like to supply, please upload here:
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