Police

Police

COMPLAINT FORM



COMPLAINANT INFORMATION
NAME:       DOB:
ADDRESS:        CITY:
ADDRESS:        STATE:     ZIP:
PHONE:      E-MAIL:


INCIDENT INFORMATION
LOCATION:      DATE/TIME:
EMPLOYEES INVOLVED:


WITNESS INFORMATION
NAME:      DOB or AGE:
ADDRESS:     CITY:


ADMONITION - The Law concerning false reports
Every person who wilfully resists, delays or obstructs any public officer, in the discharge, or attempt to discharge, of any duty of his office or who knowingly gives a false report to any peace officer, when no other punishment is prescribed, is punishable by a fine not exceeding one thousand dollars ($1,000), and imprisonment in the county jail not exceeding one (1) year.

Additionally, A person is guilty of a misdemeanor if he knowingly gives or causes to be given false information to any law enforcement officer, any state or local government agency or personnel, or to any person licensed in this state to practice social work, psychology or counseling, concerning the commission of an offense, knowing that the offense did not occur or knowing that he has no information relating to the offense or danger.

I have read and understand the above admonition, and I understand it.

COMPLAINT
In the space below, explain in your own words exactly what an Officer did, or did not do, that you believe was wrong.  Be factual, and provide ALL details concerning your complaint.


FILE ATTACHEMENT
Please attach any photos or files relevant to your complaint.  Video files are typically too large to upload.  You are requested to provide large files in person at the Police Department, located at 159 E 2nd S, Suite #1.


  I, the complainant, affirm that the information provided within this complaint form is a true and accurate accounting of the events described.



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