Police Department

Public Safety Online Complaint Form

Section 1

Online Complaint Submission Form

Please fill out this form carefully and completely.

Your Name:

Phone Number:

Email Address:

Today's Date:

Address:

Date of Incident:

Time of Incident:

Incident Location:
(i.e. address, cross street, business name, etc.)

Please state the nature of your complaint:
(include names, time, locations, witnesses, and any other information that would help in the investigation of your complaint)