Antisocial Behaviour - Community Trigger

Use this form to request ASB issues be looked at under the Community Trigger Scheme.

You will need to provide the following information so that we can deal with your report: 

1. Who you are:
   • Resident who made the original ASB report
   • Resident's Councillor
   • Family member acting on the resident's behalf
   • Resident's social worker
   • Legal representative
   • Other type of person (please provide details)
2.  Confirmation of resident's consent to sharing their information with other agencies.
3.  If you are not the resident you will need to confirm you have the resident's authority to act on their behalf and discuss the case with other agencies.
4.  Why you are applying for the Community Trigger
   • In the last 6 months, raised 3 ASB reports
   • In the last 3 months, raised a hate-related ASB report
   • In the last 6 months, you and 4 neighbours raised an ASB report
5.  Have you been advised the ASB report has been closed?  Yes / No
6.  Have you made a formal complaint about how the ASB report has been actioned?  Yes / No
7.  If Yes, please provide details.
8.  Details of original ASB report:
   • When the first report was made
   • When any further reports were made
   • Brief details of the ASB reports which relate to this trigger
   • Anything else you wish to add
9.  Who did you raise the first report with?
   • Dudley Council
   • Police (provide crime reference number and contact officer name)
   • Housing association (please specify)
   • Someone else (please provide details)
10.  Full name & address (if you are not the resident).
11.  Preferred contact method and contact details, e.g. email address, telephone number.
12.  Neighbours (names & addresses of any neighbours involved).

Please provide this information in the text box below.

Declaration

To fully investigate the Community Trigger Application, we must discuss the case and share information with other agencies, such as the Council, Police or Housing Association.  You will need to confirm that you have no objection to us discussing and sharing information with other agencies about your case in order to investigate your application for the Community Trigger.  Any representative of the resident will need to confirm they have the authority to make the application and act on the resident's behalf.

Privacy & Disclaimer Statements

The information that you provide today will be processed in accordance with Data Protection legal requirements.

To find out more about how we process your personal information please read the Community Safety Partnership Privacy Notice.

Further information can also be found within Dudley Council's Corporate Privacy & Disclaimer Statement.