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Citizen Complaint Form

Complainant Information

Name:
Address:
Phone:

Witness Information

Name:
Address:
Phone:

Incident Information

Date:
Time:
Location:
Describe Details
of the Incident:

I, the above named complainant certify that the above statement is true, accurate, and complete to the best of my knowledge. I understand the employee whom this complaint is filed against may be summoned to appear in an Administrative Hearing or an Internal Affairs Hearing. By submitting this complaint, I hereby agree to appear at any called hearing and testify to all matters relevant to this complaint. I also understand that a copy of this complaint will be forwarded to the employee. If a hearing is held, the employee and his or her attorney have a right to be present and to cross-examine me concerning any testimony that I may have