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Animal Abuse / Illegal Dog Fighting

2. Name

3. Email Address

5. Address

6. City

7. State

8. Zip Code

10. Phone Number

11. Email Address

13. Mistreatment Details

    Please give any and all details in reference to the abuse or illegal acts.

15. Mistreatment Location

    Please give any information on the location of the abuse or illegal acts.

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17. 1. Receive an email copy of this form.
18. Email address

    This field is not part of the form submission.

19. Submit

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