Citizen Complaint Form

top of page

Citizen Complaint Form

Name of Complainant

Complainant's Date of Birth required

Complainant's Telephone Number

Complainant's Address

Date of Incident required

Time of Incident

12:00 PM

Location of Incident

Name of Employee(s) Complaint To Be Made Against

Summary of the Complaint

I attest that all information entered into this form is accurate to the best of my knowledge. This form submitted under the pains and penalties of perjury.

Your submission has been sent.

bottom of page