Complaint/Recognition Form

When making a complaint please include your name, address, telephone number, and as much specific information about the subject of your complaints as possible. Please include the following information, if known:

The officer’s name
What happened
Where it happened
When it happened
Who was involved, how, and why?

Is there any RISK? No

	Date of Incident
	Location
	Type of	Allegation
	Submission	Recognition
	Office/Employee Involved
	Your Name
	Phone Number
	Address
	City
	State
	Zip Code
	Summary of Incident