Show/Hide

Citizen Complaint

Print
Please correct the field(s) marked in red below:

This page is for submitting complaints regarding specific personnel. If you have questions regarding your complaint, please contact the employee's supervisor or Department Head. 

 

1
Date of Occurrence
2
Address of Occurrence (Street, City, State)
3
Time of Occurrence (indicate AM/PM)
4

Name of Employee (please specify each name of employee if more than one)

5
Badge Number(s) (if known)
6
Explain Incident and Reason for Complaint
Your Contact Information:
7
Your Name
8
Your Complete Address
9
Your Phone
10
Your Email
Witness # 1 Contact Information:
11
Name
12
Complete Address
13
Phone
14
Email
Witness # 2 Contact Information:
15
Name
16
Complete Address
17
Phone
18
Email
  1. To receive a copy of your submission, please fill out your email address below and submit.