Notes

This form is to be completed by the person filing the affidavit for complaint investigation.

This form will be regarded as an official document upon which the complaint investigation shall have its foundation, so it is absolutely nessary that all information requested be completed in specific detail.

This report is an official Police Department report.

Do note that this form is an afficavit and when your signature is affixed to it, that signature will represent (sworn/solemn) affirmation that the information contained herein is the truth.

Officer Complaint Form:
Involved Member:
Date of Incident: / /
Time of Incident: :  
Your full name:
Your address:
Contact Number:
Summary of
Compliant:
By entering my full name below I state this affidavit for complaint investigation is true, and I request an investigation of the matters contained within. I understand this affidavit is an official Police Department report.
Signed (full name):