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Claim no.

Details of claim (continued)
4. From engaging or threatening to engage in conduct that is likely to cause intimidation, harassment, alarm and
distress to the Claimant’s employees, tenants and visitors to the block of flats at Burncroft Avenue, Enfield.
5. From engaging or threatening to engage in conduct that is likely to cause nuisance and annoyance to the
Claimant’s employees, tenants and visitors to the block of flats at Burncroft Avenue, Enfield.
6. From using his pet dog to frighten, intimidate or threaten violence to the Claimant’s employees, tenants and
visitors of the block of flats at Burncroft Avenue, Enfield.

7. A power of arrest is attached to paragraphs 3 to 6 above.
8. Costs in the case
THE LONDON BOROUGH OF ENFIELD Claimant's or claimant's legal representative's
LEGAL SERVICES
PO BOX 50 address to which documents should be sent if
CIVIC CENTRE different from overleaf. If you are prepared to
SILVER STREET accept service by DX, fax or e-mail, please add
ENFIELD details.
EN 1XA

signed position or office held Solicitor ________
(if signing on behalf of firm or company)

* delete as appropriate

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