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2. Police Department Internal Affairs Online Complaint Form
3. Choose a Language
   
   
5. Person Making Report (*Optional, but Helpful)
7. First Name
8. Last Name
9. Date of Birth
11. Address
12. City
13. State
14. Zip Code
16. Phone Number
17. Email
18. Preferred Contact Method:

    1. Phone

    1. Email
20. Personnel Subject to Allegation (Provide Whatever Info is Known)
22. Employee Name(s):
23. Badge Number(s):
25. Incident Site:
26. Date / Time
    Date / Time

    Date / Time
28. Describe the Incident:

    In the space above, describe the type of incident (traffic stop, street encounter) and any information about the alleged conduct.  If you do not know the employee's name or badge number, provide any other identifying information.

30. Other Information (How was this incident originally reported?)

    1. In Person
    2. Phone

    1. Letter
    2. Email

    1. Online Incident Reporting Form
    2. Other
32. Any physical evidence submitted?

    1. Yes

    1. No
33. If yes, describe:
35. Was incident previously reported?

    1. Yes

    1. No
36. If yes, describe:
Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit Submit and Print

* indicates a required field