Form Center

2. Name:*
3. Date of Birth:
5. Address:
7. Home Phone Number:
8. Work Phone Number:
9. Cell Phone Number:*
11. Email Address:
12. Best time to contact you?
16. I want to complain about: (Name of police employee(s) ifknown)
18. On this date:
19. At about this time:
21. He/She/They:*
25. Witness Information:
27. Name:
28. Date of Birth:
30. Address:
32. Home Phone Number:
33. Work Phone Number:
34. Cell Phone Number:
36. Name:
37. Date of Birth:
39. Address:
41. Home Phone Number:
42. Work Phone Number:
43. Cell Phone Number:
47. Complainant's Certification:
49. I hereby certify that to the best of my knowledge the statements made herein are true.*

    1. Yes
51. Notice: A complaint based on false information regarding the conduct of a law enforcement officer is a crime under state statute 946.66(2).
Leave This Blank:


53. 1. Receive an email copy of this form.
54. Email address

    This field is not part of the form submission.

55. Submit

* indicates a required field