Section 5. Sample Forms

Initial Report of Incident (Form: RH1)

(To be filled in by whoever receives the complaint)

Name of victim

Gender

Age

Ethnicity

Address

Phone

Is the victim:   Victim

Witness

Other

Is the victim a tenant:   Yes

If no, please provide details

Details of incident (time, date, place etc)

Details of alleged perpetrator(s) (age, gender, ethnicity)

Witnesses (names and addresses)

Any previous incidents

Any previous incidents reported

Other agencies involved

Police informed

Interpreter helpful

Preferred location for interview

Name of officer taking report

Signature of officer

Date

Action

1. A copy of this form should be placed on a register of racial harassment reports kept in each housing management office.
2. A copy should be put in the victim's/tenant's file.
3. A copy should be forwarded to the investigating officer.
4. A visit to investigate the complaint further must be arranged within 24 hours of the complaint having been received.