{"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\"><input id=\"gpnf_session_hash_30\" type=\"hidden\" name=\"gpnf_session_hash\" value=\"e58ae5b591f0\" 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=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_30_34'>Status<\/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' >New<\/option><option value='Complete' >Complete<\/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\">(Required)<\/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 '>First<\/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 '>Last<\/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'>Preferred Name<\/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'>Phone Number<\/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'>Email<\/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\">(Required)<\/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 '>Street Address<\/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 '>City<\/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 '>Postal Code<\/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' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' selected='selected'>Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/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' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/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' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/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' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n                                        <label for='input_30_11_6' id='input_30_11_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/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'>Yes<\/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'>No<\/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='Next'  \/> \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\">Actions<\/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 ) }\">Edit<\/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 ) }\">Delete<\/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\tThere are no <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='Next'  \/> \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=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/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\">(Required)<\/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'>Other<\/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\">(Required)<\/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'>Other<\/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'>Other<\/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='Next'  \/> \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\">(Required)<\/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'>Yes<\/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'>No<\/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\">(Required)<\/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'>Yes<\/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'>No<\/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\">(Required)<\/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=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/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='Next'  \/> \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\">(Required)<\/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' class='gform-field-label gform-field-label--type-inline'>I declare that the information I have reported is truthful<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_30_16\" class=\"gfield gfield--type-signature gfield--input-type-signature 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_16\" ><label class='gfield_label gform-field-label' for='input_30_16'>Signature<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_30_16_Container' class='gfield_signature_container ginput_container' style='height:180px; width:500px; ' ><input autocomplete=\"off\"  type='hidden' class='gform_hidden' name='input_30_16_valid' id='input_30_16_valid' \/><canvas id='input_30_16' width='500' height='180'><\/canvas><\/div><\/div><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_30' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this)' value='Previous'  \/> <input type='submit' id='gform_submit_button_30' class='gform_button button' onclick='gform.submission.handleButtonClick(this)' value='Submit'  \/> <input type='hidden' name='gform_ajax' value='form_id=30&amp;title=&amp;description=&amp;tabindex=0&amp;theme=orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_30' value='iframe' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_30' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='30' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_30' 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