Citizen Complaint Form

MM slash DD slash YYYY
MM slash DD slash YYYY
Time
:
Complainants
Name
Address
Phone
Email Address
 
Employee(s) involved
Name
Badge Number
 
Witness(s) victim(s) name and phone number
Name
Phone Number
 

I hereby affirm that the facts described in this complaint are true and correct to the best of my knowledge, and I understand that the affected employee(s) could bring civil action against me if my allegations are malicious.

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