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Citizen's Complaint Form
Received:
Date of Incident:
Location of Incident:
Time:
Phone
Walk-In
Day of Incident:
Complainant:
Address:
Home Phone#:
Employer:
Employer’s Address:
Case No: (If Applicable)
If Other, please explain:
Time of Incident:
Nature of Complaint:
Other
Date of Birth:
State:
Zip Code:
Cell Phone #:
City:
Work Phone#:
Occupation:
Employer’s Phone#:
Details of Incident: (Additional space available on second page if needed)
Personnel Complained of: (Name or Physical Description, Badge #, Car...
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