{"id":12511,"date":"2026-02-02T09:18:07","date_gmt":"2026-02-02T14:18:07","guid":{"rendered":"https:\/\/housing.county-lambton.on.ca\/?page_id=12511"},"modified":"2026-02-02T09:18:38","modified_gmt":"2026-02-02T14:18:38","slug":"complaint-form","status":"publish","type":"page","link":"https:\/\/housing.county-lambton.on.ca\/fr\/complaint-form\/","title":{"rendered":"Complaint Form"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><div class=\"vc_row wpb_row vc_row-fluid\"><style type=\"text\/css\"><\/style>     <script type=\"text\/javascript\">\n        document.addEventListener('DOMContentLoaded', function () {\n            \/\/ Function to delete a specific cookie\n            function deleteCookie(name) {\n                document.cookie = name + '=; Max-Age=-99999999;';\n            }\n\n            \/\/ Function to get all cookies\n            function getCookies() {\n                var cookies = {};\n                document.cookie.split(';').forEach(function (cookie) 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#112337;--gf-ctrl-label-color-secondary: #112337;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);--gf-ctrl-btn-border-color-secondary: #686e77;--gf-ctrl-file-btn-bg-color-hover: #EBEBEB;--gf-field-img-choice-size: var(--gf-field-img-choice-size-md);--gf-field-img-choice-card-space: var(--gf-field-img-choice-card-space-md);--gf-field-img-choice-check-ind-size: var(--gf-field-img-choice-check-ind-size-md);--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style><div id='gf_30' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_30' id='gform_30'  action='\/fr\/wp-json\/wp\/v2\/pages\/12511#gf_30' data-formid='30' novalidate autocomplete=\"off\" data-trp-original-action=\"\/fr\/wp-json\/wp\/v2\/pages\/12511#gf_30\"><input id=\"gpnf_session_hash_30\" type=\"hidden\" name=\"gpnf_session_hash\" value=\"93726ff5d4a4\" autocomplete=\"off\"> \r\n <input type='hidden' class='gforms-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/>\n        <div id='gf_progressbar_wrapper_30' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>5<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_20' style='width:20%;'><span>20%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_30_1' class='gform_page' data-js='page-field-id-0' >\n                                    <div class='gform_page_fields'><div id='gform_fields_30' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_30_40\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_40\" ><p>\nCounty of Lambton Housing Services will investigate and attempt to resolve all genuine complaints and issues within our means. We will make every reasonable effort to assist in resolving matters that arise within our communities. However, it is the responsibility of individuals to act in accordance with their <strong>Tenancy\/Occupancy Agreement<\/strong> and to attempt to resolve minor disputes before filing a formal complaint.\n<\/p>\n\n<strong>When Resolving Complaints, Housing Services will:<\/strong>\n<ul>\n  <li>Investigate all serious complaints<\/li>\n  <li>Make every reasonable effort to help resolve issues<\/li>\n  <li>Consider evicting residents who, despite all efforts to resolve the problem, continue to disrupt the reasonable enjoyment of the complex<\/li>\n  <li>Deal immediately with individuals who behave violently towards other residents or staff<\/li>\n<\/ul>\n\n<strong>When Resolving Complaints, Housing Services will not:<\/strong>\n<ul>\n  <li>Get involved in minor disputes or complaints based on rumors<\/li>\n  <li>Act on a complaint if it is discriminatory<\/li>\n  <li>Get involved if we have no authority to deal with the complaint<\/li>\n  <li>Consider evicting residents if there is limited documented evidence or no witnesses<\/li>\n<\/ul><\/div><div id=\"field_30_34\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  data-js-reload=\"field_30_34\" ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lors de la visualisation du formulaire\"><\/i><span>Ce champ est masqu\u00e9 lors de la visualisation du formulaire<\/span><\/div><label class='gfield_label gform-field-label' for='input_30_34'>Statut<\/label><div class='ginput_container ginput_container_select'><select name='input_34' id='input_30_34' class='large gfield_select'     aria-invalid=\"false\" ><option value='New' >Nouveau<\/option><option value='Complete' >Complet<\/option><\/select><\/div><\/div><div id=\"field_30_18\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_18\" ><h3 class=\"gsection_title\">Your Information<\/h3><\/div><fieldset id=\"field_30_35\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-seven-twelfths gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_35\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_30_35'>\n                            \n                            <span id='input_30_35_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input autocomplete=\"off\"  type='text' name='input_35.3' id='input_30_35_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_30_35_3' class='gform-field-label gform-field-label--type-sub'>D&#039;abord<\/label>\n                                                <\/span>\n                            \n                            <span id='input_30_35_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input autocomplete=\"off\"  type='text' name='input_35.6' id='input_30_35_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_30_35_6' class='gform-field-label gform-field-label--type-sub'>Dernier<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_30_10\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-five-twelfths field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_10\" ><label class='gfield_label gform-field-label' for='input_30_10'>Nom pr\u00e9f\u00e9r\u00e9<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_10' id='input_30_10' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_30_12\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_12\" ><label class='gfield_label gform-field-label' for='input_30_12'>Num\u00e9ro de t\u00e9l\u00e9phone<\/label><div class='ginput_container ginput_container_phone'><input autocomplete=\"off\"  name='input_12' id='input_30_12' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_30_13\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_13\" ><label class='gfield_label gform-field-label' for='input_30_13'>E-mail<\/label><div class='ginput_container ginput_container_email'>\n                            <input autocomplete=\"off\"  name='input_13' id='input_30_13' type='email' value='' class='large'     aria-invalid=\"false\" aria-describedby=\"gfield_description_30_13\" \/>\n                        <\/div><div class='gfield_description' id='gfield_description_30_13'>Please enter an Email if you would like an emailed copy<\/div><\/div><fieldset id=\"field_30_11\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_11\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Your Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_30_11' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_30_11_1_container' >\n                                        <input autocomplete=\"off\"  type='text' name='input_11.1' id='input_30_11_1' value=''    aria-required='true'    \/>\n                                        <label for='input_30_11_1' id='input_30_11_1_label' class='gform-field-label gform-field-label--type-sub'>Adresse de la rue<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_30_11_2_container' >\n                                        <input autocomplete=\"off\"  type='text' name='input_11.2' id='input_30_11_2' value=''     aria-required='false'   \/>\n                                        <label for='input_30_11_2' id='input_30_11_2_label' class='gform-field-label gform-field-label--type-sub'>Unit No<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_30_11_3_container' >\n                                    <input autocomplete=\"off\"  type='text' name='input_11.3' id='input_30_11_3' value=''    aria-required='true'    \/>\n                                    <label for='input_30_11_3' id='input_30_11_3_label' class='gform-field-label gform-field-label--type-sub'>Ville<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_30_11_4_container' >\n                                        <input autocomplete=\"off\"  type='text' name='input_11.4' id='input_30_11_4' value=''      aria-required='true'    \/>\n                                        <label for='input_30_11_4' id='input_30_11_4_label' class='gform-field-label gform-field-label--type-sub'>Province<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_30_11_5_container' >\n                                    <input autocomplete=\"off\"  type='text' name='input_11.5' id='input_30_11_5' value=''    aria-required='true'    \/>\n                                    <label for='input_30_11_5' id='input_30_11_5_label' class='gform-field-label gform-field-label--type-sub'>Code Postal<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_30_11_6_container' >\n                                        <select name='input_11.6' id='input_30_11_6'   aria-required='true'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albanie<\/option><option value='Algeria' >Alg\u00e9rie<\/option><option value='American Samoa' >Samoa am\u00e9ricaines<\/option><option value='Andorra' >Andorre<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctique<\/option><option value='Antigua and Barbuda' >Antigua-et-Barbuda<\/option><option value='Argentina' >Argentine<\/option><option value='Armenia' >Arm\u00e9nie<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australie<\/option><option value='Austria' >Autriche<\/option><option value='Azerbaijan' >Azerba\u00efdjan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahre\u00efn<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbade<\/option><option value='Belarus' >Bi\u00e9lorussie<\/option><option value='Belgium' >Belgique<\/option><option value='Belize' >B\u00e9lize<\/option><option value='Benin' >B\u00e9nin<\/option><option value='Bermuda' >Bermudes<\/option><option value='Bhutan' >Bhoutan<\/option><option value='Bolivia' >Bolivie<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Saint-Eustache et Saba<\/option><option value='Bosnia and Herzegovina' >Bosnie-Herz\u00e9govine<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Ile Bouvet<\/option><option value='Brazil' >Br\u00e9sil<\/option><option value='British Indian Ocean Territory' >Territoire britannique de l&#039;oc\u00e9an Indien<\/option><option value='Brunei Darussalam' >Brun\u00e9i Darussalam<\/option><option value='Bulgaria' >Bulgarie<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cap-Vert<\/option><option value='Cambodia' >Cambodge<\/option><option value='Cameroon' >Cameroun<\/option><option value='Canada' selected='selected'>Canada<\/option><option value='Cayman Islands' >\u00celes Ca\u00efmans<\/option><option value='Central African Republic' >R\u00e9publique centrafricaine<\/option><option value='Chad' >Tchad<\/option><option value='Chile' >Chili<\/option><option value='China' >Chine<\/option><option value='Christmas Island' >L&#039;\u00eele Christmas<\/option><option value='Cocos Islands' >\u00celes Cocos<\/option><option value='Colombia' >Colombie<\/option><option value='Comoros' >Comores<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, R\u00e9publique d\u00e9mocratique du<\/option><option value='Cook Islands' >\u00celes Cook<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatie<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Chypre<\/option><option value='Czechia' >Tch\u00e9quie<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Danemark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominique<\/option><option value='Dominican Republic' >R\u00e9publique dominicaine<\/option><option value='Ecuador' >\u00c9quateur<\/option><option value='Egypt' >Egypte<\/option><option value='El Salvador' >Le Salvador<\/option><option value='Equatorial Guinea' >Guin\u00e9e \u00e9quatoriale<\/option><option value='Eritrea' >\u00c9rythr\u00e9e<\/option><option value='Estonia' >Estonie<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopie<\/option><option value='Falkland Islands' >\u00celes Malouines<\/option><option value='Faroe Islands' >\u00celes F\u00e9ro\u00e9<\/option><option value='Fiji' >Fidji<\/option><option value='Finland' >Finlande<\/option><option value='France' >France<\/option><option value='French Guiana' >Guyane fran\u00e7aise<\/option><option value='French Polynesia' >Polyn\u00e9sie fran\u00e7aise<\/option><option value='French Southern Territories' >Terres Australes Fran\u00e7aises<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambie<\/option><option value='Georgia' >G\u00e9orgie<\/option><option value='Germany' >Allemagne<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Gr\u00e8ce<\/option><option value='Greenland' >Groenland<\/option><option value='Grenada' >Grenade<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernesey<\/option><option value='Guinea' >Guin\u00e9e<\/option><option value='Guinea-Bissau' >Guin\u00e9e-Bissau<\/option><option value='Guyana' >Guyane<\/option><option value='Haiti' >Ha\u00efti<\/option><option value='Heard Island and McDonald Islands' >\u00celes Heard et McDonald<\/option><option value='Holy See' >Saint-Si\u00e8ge<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hongrie<\/option><option value='Iceland' >Islande<\/option><option value='India' >Inde<\/option><option value='Indonesia' >Indon\u00e9sie<\/option><option value='Iran' >L&#039;Iran<\/option><option value='Iraq' >Irak<\/option><option value='Ireland' >Irlande<\/option><option value='Isle of Man' >\u00cele de Man<\/option><option value='Israel' >Isra\u00ebl<\/option><option value='Italy' >Italie<\/option><option value='Jamaica' >Jama\u00efque<\/option><option value='Japan' >Japon<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordanie<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Cor\u00e9e, R\u00e9publique populaire d\u00e9mocratique de<\/option><option value='Korea, Republic of' >Cor\u00e9e, R\u00e9publique de<\/option><option value='Kuwait' >Koweit<\/option><option value='Kyrgyzstan' >Kirghizistan<\/option><option value='Lao People&#039;s Democratic Republic' >R\u00e9publique d\u00e9mocratique populaire lao<\/option><option value='Latvia' >Lettonie<\/option><option value='Lebanon' >Liban<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Lib\u00e9ria<\/option><option value='Libya' >Libye<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lituanie<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaisie<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malte<\/option><option value='Marshall Islands' >\u00celes Marshall<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritanie<\/option><option value='Mauritius' >Ile Maurice<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexique<\/option><option value='Micronesia' >Micron\u00e9sie<\/option><option value='Moldova' >Moldavie<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolie<\/option><option value='Montenegro' >Mont\u00e9n\u00e9gro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Maroc<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Birmanie<\/option><option value='Namibia' >Namibie<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >N\u00e9pal<\/option><option value='Netherlands' >Pays-Bas<\/option><option value='New Caledonia' >Nouvelle-Cal\u00e9donie<\/option><option value='New Zealand' >Nouvelle-Z\u00e9lande<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >\u00cele Norfolk<\/option><option value='North Macedonia' >Mac\u00e9doine du Nord<\/option><option value='Northern Mariana Islands' >\u00celes Mariannes du Nord<\/option><option value='Norway' >Norv\u00e8ge<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palaos<\/option><option value='Palestine, State of' >Palestine, \u00c9tat de<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papouasie-Nouvelle-Guin\u00e9e<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >P\u00e9rou<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Pologne<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Porto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Roumanie<\/option><option value='Russian Federation' >F\u00e9d\u00e9ration de Russie<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint-Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Sainte-H\u00e9l\u00e8ne, Ascension et Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint-Kitts-et-Nevis<\/option><option value='Saint Lucia' >Sainte-Lucie<\/option><option value='Saint Martin' >Saint-Martin<\/option><option value='Saint Pierre and Miquelon' >Saint-Pierre-et-Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint-Vincent-et-les Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >Saint-Marin<\/option><option value='Sao Tome and Principe' >Sao Tom\u00e9-et-Principe<\/option><option value='Saudi Arabia' >Arabie Saoudite<\/option><option value='Senegal' >S\u00e9n\u00e9gal<\/option><option value='Serbia' >Serbie<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapour<\/option><option value='Sint Maarten' >Saint-Martin<\/option><option value='Slovakia' >Slovaquie<\/option><option value='Slovenia' >Slov\u00e9nie<\/option><option value='Solomon Islands' >\u00celes Salomon<\/option><option value='Somalia' >Somalie<\/option><option value='South Africa' >Afrique du Sud<\/option><option value='South Georgia and the South Sandwich Islands' >G\u00e9orgie du Sud et les \u00eeles Sandwich du Sud<\/option><option value='South Sudan' >Soudan du Sud<\/option><option value='Spain' >Espagne<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Soudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard et Jan Mayen<\/option><option value='Sweden' >Su\u00e8de<\/option><option value='Switzerland' >Suisse<\/option><option value='Syria Arab Republic' >R\u00e9publique arabe syrienne<\/option><option value='Taiwan' >Ta\u00efwan<\/option><option value='Tajikistan' >Tadjikistan<\/option><option value='Tanzania, the United Republic of' >Tanzanie, R\u00e9publique-Unie de<\/option><option value='Thailand' >Tha\u00eflande<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Aller<\/option><option value='Tokelau' >Tok\u00e9laou<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinit\u00e9-et-Tobago<\/option><option value='Tunisia' >Tunisie<\/option><option value='Turkmenistan' >Turkm\u00e9nistan<\/option><option value='Turks and Caicos Islands' >\u00celes Turques-et-Ca\u00efques<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >Turquie<\/option><option value='US Minor Outlying Islands' >\u00celes mineures \u00e9loign\u00e9es des \u00c9tats-Unis<\/option><option value='Uganda' >Ouganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >\u00c9mirats arabes unis<\/option><option value='United Kingdom' >Royaume-Uni<\/option><option value='United States' >\u00c9tats-Unis<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Ouzb\u00e9kistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Vietnam<\/option><option value='Virgin Islands, British' >\u00celes Vierges britanniques<\/option><option value='Virgin Islands, U.S.' >\u00celes Vierges am\u00e9ricaines<\/option><option value='Wallis and Futuna' >Wallis et Futuna<\/option><option value='Western Sahara' >Sahara occidental<\/option><option value='Yemen' >Y\u00e9men<\/option><option value='Zambia' >Zambie<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00celes \u00c5land<\/option><\/select>\n                                        <label for='input_30_11_6' id='input_30_11_6_label' class='gform-field-label gform-field-label--type-sub'>Pays<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_30_38\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_38\" ><legend class='gfield_label gform-field-label' >Are you willing to povide evidence in this matter at a hearing or mediation meeting?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_38'>\n\t\t\t<div class='gchoice gchoice_30_38_0'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_38' type='radio' value='Yes'  id='choice_30_38_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_38_0' id='label_30_38_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_38_1'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_38' type='radio' value='No'  id='choice_30_38_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_38_1' id='label_30_38_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_30_41' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this)' value='Suivant'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_30_2' class='gform_page' data-js='page-field-id-41' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_30_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_30_17\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_17\" ><h3 class=\"gsection_title\">Details of Complaint<\/h3><\/div><div id=\"field_30_30\" class=\"gfield gfield--type-form gfield--input-type-form gform-theme__no-reset--children gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_30\" ><label class='gfield_label gform-field-label' for='input_30_30'>Complaint Dates<\/label><div class=\"gpnf-nested-entries-container ginput_container\">\n\n\t<table class=\"gpnf-nested-entries\">\n\n\t\t<thead>\n\t\t<tr>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-1\">\n\t\t\t\t\tDate\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-2\">\n\t\t\t\t\tTime\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-3\">\n\t\t\t\t\tWere the Police called?\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-4\">\n\t\t\t\t\tIncident Number\t\t\t\t<\/th>\n\t\t\t\t\t\t<th class=\"gpnf-row-actions\"><span class=\"screen-reader-text\">Actes<\/span><\/th>\n\t\t<\/tr>\n\t\t<\/thead>\n\n\t\t<tbody data-bind=\"visible: entries().length, foreach: entries\">\n\t\t<tr data-bind=\"attr: { 'data-entryid': id }\">\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f1.label, attr: { 'data-value': f1.label }\"\n\t\t\t\t\tdata-heading=\"Date\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f2.label, attr: { 'data-value': f2.label }\"\n\t\t\t\t\tdata-heading=\"Time\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f3.label, attr: { 'data-value': f3.label }\"\n\t\t\t\t\tdata-heading=\"Were the Police called?\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f4.label, attr: { 'data-value': f4.label }\"\n\t\t\t\t\tdata-heading=\"Incident Number\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t<td class=\"gpnf-row-actions\" style=\"display: none;\" data-bind=\"visible: true\">\n\t\t\t\t<ul>\n\t\t\t\t\t<li class=\"edit\"><button type=\"button\" class=\"edit-button gform-theme-button--secondary\" data-bind=\"click: $parent.editEntry, attr: { 'aria-label': 'Edit Date {0} where Date is {1}.'.gformFormat( $index() + 1, f1.label ) }\">Modifier<\/button><\/li>\n\t\t\t\t\t\t\t\t\t\t<li class=\"delete\"><button type=\"button\" class=\"delete-button gform-theme-button--simple gform-theme-button--size-md\" data-bind=\"click: $parent.deleteEntry, attr: { 'aria-label': 'Delete Date {0} where Date is {1}.'.gformFormat( $index() + 1, f1.label ) }\">Supprimer<\/button><\/li>\n\t\t\t\t<\/ul>\n\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t\t<tbody data-bind=\"visible: entries().length <= 0\">\n\t\t<tr class=\"gpnf-no-entries\" data-bind=\"visible: entries().length <= 0\" style=\"display: none;\">\n\t\t\t<td colspan=\"5\">\n\t\t\t\tIl n&#039;y a pas de <span>Dates.<\/span>\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t<\/table>\n\n\t<button type=\"button\" class=\"gpnf-add-entry\"\n\t\t        data-formid=\"30\"\n\t\t        data-nestedformid=\"31\"\n\t\t\t\tdata-bind=\"attr: { disabled: isMaxed }, css: { 'gf-default-disabled': isMaxed }\"\n\t\t\t\t>\n\t\t\t\tAdd Date\n\t\t\t<\/button>\t\n\t\t\t<p class=\"gpnf-add-entry-max\" data-bind=\"visible: isMaxed\" style=\"display: none;\">\n\t\t\t\tMaximum number of dates reached.\n\t\t\t<\/p>\n<\/div>\n<input autocomplete=\"off\"  type=\"hidden\"\n                name=\"input_30\"\n                id=\"input_30_30\"\n                data-bind=\"value: entryIds\"\n                value=\"\" \/><div class='gfield_description' id='gfield_description_30_30'>Please list the Dates and Times of when this Incident occurred<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_30_42' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this)' value='Previous'  \/> <input type='button' id='gform_next_button_30_42' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this)' value='Suivant'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_30_3' class='gform_page' data-js='page-field-id-42' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_30_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_30_29\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_29\" ><h3 class=\"gsection_title\">Nature of Incident<\/h3><\/div><fieldset id=\"field_30_8\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  data-js-reload=\"field_30_8\" ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lors de la visualisation du formulaire\"><\/i><span>Ce champ est masqu\u00e9 lors de la visualisation du formulaire<\/span><\/div><legend class='gfield_label gform-field-label' >Please select one of the options below that describes the nature of the incident.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_8'>\n\t\t\t<div class='gchoice gchoice_30_8_0'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_8' type='radio' value='Damage'  id='choice_30_8_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_8_0' id='label_30_8_0' class='gform-field-label gform-field-label--type-inline'>Damage<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_8_1'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_8' type='radio' value='Neighbour Dispute Safety'  id='choice_30_8_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_8_1' id='label_30_8_1' class='gform-field-label gform-field-label--type-inline'>Neighbour Dispute Safety<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_8_2'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_8' type='radio' value='Noise Complaint'  id='choice_30_8_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_8_2' id='label_30_8_2' class='gform-field-label gform-field-label--type-inline'>Noise Complaint<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_8_3'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_8' type='radio' value='Pet Issue'  id='choice_30_8_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_8_3' id='label_30_8_3' class='gform-field-label gform-field-label--type-inline'>Pet Issue<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_8_4'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_8' type='radio' value='Physical Violence'  id='choice_30_8_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_8_4' id='label_30_8_4' class='gform-field-label gform-field-label--type-inline'>Physical Violence<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_8_5'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_8' type='radio' value='Safety'  id='choice_30_8_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_8_5' id='label_30_8_5' class='gform-field-label gform-field-label--type-inline'>Safety<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_8_6'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_8' type='radio' value='Theft'  id='choice_30_8_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_8_6' id='label_30_8_6' class='gform-field-label gform-field-label--type-inline'>Theft<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_8_7'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_8' type='radio' value='gf_other_choice'  id='choice_30_8_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_8_7' id='label_30_8_7' class='gform-field-label gform-field-label--type-inline'>Autre<\/label><br \/><input autocomplete=\"off\"  id='input_30_8_other' class='gchoice_other_control' name='input_8_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_30_36\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_36\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Please select all that describe the nature of the incident.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_30_36'><div class='gchoice gchoice_30_36_1'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_36.1' type='checkbox'  value='Damage'  id='choice_30_36_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_36_1' id='label_30_36_1' class='gform-field-label gform-field-label--type-inline'>Damage<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_36_2'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_36.2' type='checkbox'  value='Neighbour Dispute Safety'  id='choice_30_36_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_36_2' id='label_30_36_2' class='gform-field-label gform-field-label--type-inline'>Neighbour Dispute Safety<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_36_3'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_36.3' type='checkbox'  value='Noise Complaint'  id='choice_30_36_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_36_3' id='label_30_36_3' class='gform-field-label gform-field-label--type-inline'>Noise Complaint<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_36_4'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_36.4' type='checkbox'  value='Pet Issue'  id='choice_30_36_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_36_4' id='label_30_36_4' class='gform-field-label gform-field-label--type-inline'>Pet Issue<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_36_5'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_36.5' type='checkbox'  value='Physical Violence'  id='choice_30_36_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_36_5' id='label_30_36_5' class='gform-field-label gform-field-label--type-inline'>Physical Violence<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_36_6'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_36.6' type='checkbox'  value='Safety'  id='choice_30_36_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_36_6' id='label_30_36_6' class='gform-field-label gform-field-label--type-inline'>Safety<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_36_7'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_36.7' type='checkbox'  value='Theft'  id='choice_30_36_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_36_7' id='label_30_36_7' class='gform-field-label gform-field-label--type-inline'>Theft<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_30_36_8'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_36.8' type='checkbox'  value='Other'  id='choice_30_36_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_36_8' id='label_30_36_8' class='gform-field-label gform-field-label--type-inline'>Autre<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_30_37\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_37\" ><label class='gfield_label gform-field-label' for='input_30_37'>Autre<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_37' id='input_30_37' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_30_44' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this)' value='Previous'  \/> <input type='button' id='gform_next_button_30_44' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this)' value='Suivant'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_30_4' class='gform_page' data-js='page-field-id-44' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_30_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_30_3\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gf-row-2 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_3\" ><legend class='gfield_label gform-field-label' >Was Anything Damaged?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_3'>\n\t\t\t<div class='gchoice gchoice_30_3_0'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_3' type='radio' value='Yes'  id='choice_30_3_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_3_0' id='label_30_3_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_3_1'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_3' type='radio' value='No'  id='choice_30_3_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_3_1' id='label_30_3_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_30_5\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-half gf-row-2 field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_5\" ><label class='gfield_label gform-field-label' for='input_30_5'>Please tell us what was damaged<\/label><div class='ginput_container ginput_container_textarea'><textarea autocomplete=\"off\"  name='input_5' id='input_30_5' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_30_39\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_39\" ><label class='gfield_label gform-field-label' for='gform_browse_button_30_39'>Upload images of damages<\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_30_39' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_30_39&quot;,&quot;container&quot;:&quot;gform_multifile_upload_30_39&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_30_39&quot;,&quot;filelist&quot;:&quot;gform_preview_30_39&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/?gf_page=6e09d9d2b26667e&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/housing.county-lambton.on.ca\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;jpg,jpeg,gif,png,heic,pdf,doc,docx&quot;}],&quot;max_file_size&quot;:&quot;10485760b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:30,&quot;field_id&quot;:39},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_30_39&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_30_39' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_30_39' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_30_39\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_30_39'>Accepted file types: jpg, jpeg, gif, png, heic, pdf, doc, docx, Max. file size: 10 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_30_39'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_30_39' class='ginput_preview_list'><\/div><\/div><div id=\"field_30_28\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_28\" ><\/div><fieldset id=\"field_30_6\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gf-row-3 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_6\" ><legend class='gfield_label gform-field-label' >Was Anyone Hurt?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_30_6'>\n\t\t\t<div class='gchoice gchoice_30_6_0'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_6' type='radio' value='Yes'  id='choice_30_6_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_6_0' id='label_30_6_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_30_6_1'>\n\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_6' type='radio' value='No'  id='choice_30_6_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_30_6_1' id='label_30_6_1' class='gform-field-label gform-field-label--type-inline'>Non<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_30_7\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-half gf-row-3 field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_7\" ><label class='gfield_label gform-field-label' for='input_30_7'>Please tell us about the injury<\/label><div class='ginput_container ginput_container_textarea'><textarea autocomplete=\"off\"  name='input_7' id='input_30_7' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_30_26\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_26\" ><\/div><div id=\"field_30_9\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_9\" ><label class='gfield_label gform-field-label' for='input_30_9'>Please provide a brief description of the incident<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea autocomplete=\"off\"  name='input_9' id='input_30_9' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_30_31\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_hidden\"  data-js-reload=\"field_30_31\" ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Ce champ est masqu\u00e9 lors de la visualisation du formulaire\"><\/i><span>Ce champ est masqu\u00e9 lors de la visualisation du formulaire<\/span><\/div><label class='gfield_label gform-field-label' for='input_30_31'>Additional Details<\/label><div class='ginput_container ginput_container_textarea'><textarea autocomplete=\"off\"  name='input_31' id='input_30_31' class='textarea large'  aria-describedby=\"gfield_description_30_31\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_30_31'>Please provide any additional details in relation to this incident<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_30_45' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this)' value='Previous'  \/> <input type='button' id='gform_next_button_30_45' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this)' value='Suivant'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_30_5' class='gform_page' data-js='page-field-id-45' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_30_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_30_32\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_32\" ><h3 class=\"gsection_title\">Declaration<\/h3><\/div><div id=\"field_30_33\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_33\" >Personal information contained in this form or in any attachments is collected by County of Lambton Housing Services Department in accordance with the Freedom of Information and Protection of Privacy Act or the Municipal Freedom of Information and Protection of Privacy Act and will be used only as set out in this form.<\/div><fieldset id=\"field_30_14\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_30_14\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Untitled<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Requis)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_30_14'><div class='gchoice gchoice_30_14_1'>\n\t\t\t\t\t\t\t\t<input autocomplete=\"off\"  class='gfield-choice-input' name='input_14.1' type='checkbox'  value='I declare that the information I have reported is truthful'  id='choice_30_14_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_30_14_1' id='label_30_14_1' 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