Comment/Complaint Form
Printable Version
Please provide the following contact information:
Name: _____________________________
Address: ____________________________
Telephone: ________________
Today's Date: _______________
I wish to file a formal complaint against: ____________________
Reason: _______________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________
Please complete the following questions:
Date of Incident: __________ Time of Incident: _________
Witnesses: Y N Name:_____________________
Name:_____________________
Police Called: Y N Officer's Name: ____________________
I have completed the above information to the best of my knowledge or belief. I understand that by placing a false complaint I am committing fraud and it is punishable by law. I understand that by placing a written complaint, I may need to testify to the facts as I know them in Magistrate's Court any/or any other legal proceedings.
_____________________________ _____________
Signature Date
