Citizen Complaint Report Form

Citizens may report their complaints regarding a police officers conduct.

	Complainant's Information
First Name:	A value is required.
Middle Name:	A value is required.
Last Name:	A value is required.
Email Address:	A value is required.
Sex:	A value is required.
Date of Birth:	A value is required.
Home Address:	A value is required.
Home Phone Number:	A value is required.
Business Address:	A value is required.
Business Phone Number:	A value is required.
	Additonal Complainant Information
Full Name:	A value is required.
Phone Number:	A value is required.
Address:	A value is required.
	Additonal Complainant Information
Full Name:	A value is required.
Phone Number:	A value is required.
Address:	A value is required.
	Incident Description
Nature of Complaint:	A value is required.
Location of Occurance:	A value is required.
Date of Incident:	A value is required.
Time of Incident:	A value is required.
Accused Employee Name:	A value is required.
Badge ID Number:	A value is required.
Assignment:	A value is required.
Description of Complaint: Please be as specific as possible	A value is required.
	Complainant's Certification
I swear or affirm that the above information is factual and correct. I understand that if said facts and allegations are proven to be false I may be prosecuted under Minnesota Criminal Code Chapter 609.48 - Perjury (A felony punishable by imprisonment for not more than five years or a fine of not more than $10,000, or both) and/or other applicable law and possibly subject to civil liability. I certify that the foregoing complaint is true and correct and that my signature acknowledging the same is a free act and deed.
Today's Date:	A value is required.
Full Name:	A value is required.
Please note: you may be required to submit a handwritten signature, in person, before your electronic form can be processed. We will contact you if your handwritten signature is required for processing.