Campbell Police Department Citizen Complaint Form

Complainant

Name

Address

City

State

Zip code

Telephone (Cell)

Telephone (Home)

Enter your email address to be emailed a copy of your submission.

Date

Month

Day

Year

Time

: Hour

Minute

Officer/Employee Identification

#1

#2

Citizen/Officer Incident

Complaint Against*

(Employee/Officer)

of:

Town of Campbell Police Department
Town of Campbell Police Reserves

Date of Incident*

Month

Day

Year

Time of Incident

: Hour

Minute

Location of Incident

Type of Incident

MISC.

Witnesses

Witness 1 Name:

Witness 1 Address:

Witness 1 City:

Witness 1 State:

Witness 1 Zip:

Witness 1 Phone:

Witness 2 Name:

Witness 2 Address:

Witness 2 City:

Witness 2 State:

Witness 2 Zip:

Witness 2 Phone:

Witness 3 Name:

Witness 3 Address:

Witness 3 City:

Witness 3 State:

Witness 3 Zip:

Witness 3 Phone:

Witness 4 Name:

Witness 4 Address:

Witness 4 City:

Witness 4 Zip:

Witness 4 Phone:

Witness 5 Name:

Witness 5 Address:

Witness 5 City:

Witness 5 Zip:

Witness 5 Phone:

Any Miscellaneous Additional Information:

Detailed Statement Of Complaint:

CAPTCHA