File a Complaint via Email

Date: -- mm/dd/yy

Please provide the following contact information:

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail

How do you want us to contact you? Select any of the following options that apply:

Home Phone
Work Phone
Mail
Email

Location or address where the incident occurred:

Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

Police report number:

Date of the incident:

-- mm/dd/yy

Time of the incident:

-- hh:mm:ss am/pm

Was someone arrested?

Yes No

Officer(s) or employee(s) involved:

Name

Please provide the following witness information:

Name
Work Phone
Home Phone
E-mail
Name
Work Phone
Home Phone
E-mail
Name
Work Phone
Home Phone
E-mail

Briefly describe what happened:

How would you like to see this complaint resolved? Choose one of the following options:

I would like to have more information about this incident.
I want to file an Internal Affairs complaint.