Employee Complaint Form

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Complaint Against Employee

Every citizen has the right to make a complaint against an employee of the Police Department. The complaint may be made to any supervisor or the Internal Affairs Division. A complaint may be made in person, by telephone, by mail, or by a person not directly involved in the incident. Complaints may also be made anonymously. The Department will release to the complaining party a copy of his or her own statement.

Once a complaint is received, the following procedure is followed:

1. The complaint is forwarded to the Internal Affairs Division.

2. You will receive a letter or email acknowledging receipt of your complaint.

3. The Department will investigate your complaint.

4. We will notify you of the results of the investigation.

CAD Incident #

Complaint Type

Date of Complaint

Time of Complaint

Individual Filing the Complaint

Enter your personal information so we may contact you directly if our investigators have any additional questions and to notify you upon completion of our investigation.

You may remain anonymous by checking the appropriate checkbox; however, we will have no means to notify you of the outcome of the investigation. If you complete this form on behalf of another, please provide your information in addition to the individual's information on whose behalf you are submitting this complaint.

I want to remain anonymous.

Complainant is a minor/needs help.

Adult Information

First Name

Middle Name

Last Name

Address

City

State

Zip

Home phone

Cell phone

Relationship to Complimenter

Best time to contact?

Primary Language Spoken

Can you communicate in English?

Complainant Information

First Name

Middle Name

Last Name

Address

City

State

Zip

Home phone

Cell phone

Additional phone

Additional Email

Date of Birth

Age

Race

Gender

Driver's License #

Disability

Best time to contact?

Primary Language Spoken

Can you communicate in English?

Arrested?

Citation Number

Injury Information

Was complainant injured during the incident?

Attorney Information

Attorney's Name

Attorney's Phone

Witness

Witness Information

First name

Middle Name

Last Name

Address

City

State

Zip

Home phone

Cell phone

Additional phone

Additional Email

Date of Birth

Age

Race

Gender

Driver's License #

Relationship to Complainant

Witness Relationship to Employee

Employee Name

Relationship to Employee

Add another witness

Witness Information

First name

Middle Name

Last Name

Address

City

State

Zip

Home phone

Cell phone

Additional phone

Additional Email

Date of Birth

Age

Race

Gender

Driver's License #

Relationship to Complainant

Witness Relationship to Employee

Employee Name

Relationship to Employee

Add another witness

Witness Information

First name

Middle Name

Last Name

Address

City

State

Zip

Home phone

Cell phone

Additional phone

Additional Email

Date of Birth

Age

Race

Gender

Driver's License #

Relationship to Complainant

Witness Relationship to Employee

Employee Name

Relationship to Employee

Employee

Employee Information

Employee #

First name

Middle Name

Last Name

Age

Race

Gender

In Uniform

Division

Unit

Description of Employee

Vehicle Information

Vehicle Make

Vehicle Model

Vehicle Color

Vehicle Number

Vehicle Characteristics

Add another employee

Employee Information

Employee #

First name

Middle Name

Last Name

Age

Race

Gender

In Uniform

Division

Unit

Description of Employee

Vehicle Information

Vehicle Make

Vehicle Model

Vehicle Color

Vehicle Number

Vehicle Characteristics

Add another employee

Employee Information

Employee #

First name

Middle Name

Last Name

Age

Race

Gender

In Uniform

Division

Unit

Description of Employee

Vehicle Information

Vehicle Make

Vehicle Model

Vehicle Color

Vehicle Number

Vehicle Characteristics

Incident

Date of Incident

Date of Incident

Day of Incident

Time of Incident

Incident Location

Address

City

State

Zip

Incident Description

Supporting Documentation

Attachment(s) supporting complaint:

Attach another document

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