Citizen Complaint Form

2. Full name of person filing complaint*
4. Address of person filing complaint*
6. Telephone Number*
7. Additional phone number if wanted
9. Date of Birth*
11. Below, please list any witnesses (if any) that were present during your interaction with our department.
13. Full name of witness #1
15. Address (if known) of witness #1
16. Phone number (if known) of witness #1
18. Full name of witness #2
20. Address (if known) of witness #2
21. Phone number (if known) of witness #2
23. Full name of witness #3
25. Address (if known) of witness #3
26. Phone number (if known) of witness #3
28. Additional information, if needed.
30. Below, list any officers/personnel this complaint is about, with their name and/or badge number.
32. Officer #1*
33. Officer #2
34. Officer #3
36. Additional information, if needed.
38. Below, please describe the type of incident this complaint is about (traffic stop, theft report, etc.)
40. Type of incident*
42. Date/Time of incident*
    Date/Time of incident

    Date/Time of incident
43. Police report/incident number (if known)
45. Below, please type out, as detailed as possible, the reason for this complaint*
Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit

* indicates a required field