NOTE: Fields marked with an "*" are required and must be filled in to submit the form.
Current Date
Case Number
The purpose of this report is to file a:
Against an:
   
Person Making Report  
Name
Address
City
State
Zip Code
Email
Phone Number
Cell Number
   
Complaint Against or Commendation for  
Name
Badge #
Bureau
   
Incident Details  
Date of Incident  
Time of Incident  
Location  
*Describe in as much detail as you can remember the events leading up to, during and after the incident.