Citizen Complaint/Officer Commendation Form

Date:

*Please list the reason for your feedback:

Complaint

Commendation

Name:

Address:

Home Phone:

Work Phone:

Employee the complaint is being made against or employee being commended:

Nature of Complaint or Commendation:

Location of Incident:

Date and Time Incident Occurred:

Please list any witnesses (include names, sex, DOB, and address information):

Narrative:

I verify that the information contained in the form is true and accurate to the best of my memory. I further understand that knowingly making a false complaint is a misdemeanor and, as such, is punishable by law.

*Electronic Signature: