1. About you

2. Your Litter Reporter Number*

   IMPORTANT: You must be registered as a Litter Reporter before your report can be processed. Register via the link above prior to completing this form. Include your mobile number here if you have not been assigned a litter reporter number yet.

3. Your email*

4. The vehicle

5. Vehicle type* Please select... 4WD Boat Bus Convertible Coupe Hatchback Motorbike Sedan Station wagon Trailer Truck Ute / Tray back Van People Mover SUV UNKNOWN vehicle shape
6. Licence number*
7. Make / Model*
8. Vehicle colour*
9. Distinguishing vehicle features*

   Please attach photographs in the additional information section below. Photographs can also be emailed to kabc@kabc.wa.gov.au. Video evidence may be sent via Dropbox, email us for details.

10. The person

11. Offence by* Please select... Driver Front passenger Rear left passenger Rear right passenger (drivers side)
12. Offenders gender* Please select... Female Male Unknown
13. Description of offender*

    Description of offender (include values such as age, hair type,hair colour, tatoos, clothing etc)

14. The location of the incident

15. Offence location (street)*
16. Cross street (or nearest intersection)*
17. Suburb*

18. Date and time

19. Date of offence*
20. Time of the offence*

Time of day*

AMPM

21. The situation

22. Direction of travel Please select... North South East West
23. Surrounding area

    (eg bushland, paddock, suburban, coastal)

Weather Conditions*

HotSunnyClearOvercastRainHeavy RainWindyFog

24. Please indicate how you saw the item(s) being deposited Please select... From the vehicle Before getting into the vehicle After getting out of the vehicle Unsecured load Illegally dumped

If unsecured load, tick all relevant boxes

No securings or coveringsNo ropes or strapsTied down with ropes or strapsNo tarpaulinCovered with tarpaulin or coveringFell or blew off vehicleEscaped from covered load

25. The offence

26. Description of the offence

    Please give as much information as possible regarding the incident

27. Type of litter*

    If you have witnessed a LIT CIGARETTE BUTT please indicate how you knew it was lit.

28. Supporting evidence

29. Photographic evidence

    If your photo is too large to upload please share via Dropbox or email directly to kabc@kabc.wa.gov.au.

30. Photographic evidence (additional photo)
31. Supporting evidence

    Eg: Notes made at the time/ voice recording/ other witnesses

Confirmation*

I confirm

Click the box to confirm that all entries are correct

* denotes a required field.