Skip to content Skip to left sidebar Skip to footer

POLICE INTERNAL AFFAIRS

POLICE COMPLAINT FORM

    TEST MODE TEST MODE TEST MODE
    NOT ACTIVE CURRENTLY
    Department/Agency _________________________________ IA Case Number _________________________________

    INTERNAL AFFAIRS REPORT FORM

    Person Making Report (Optional, But Helpful)






    Preferred Method of Contact
    PHONEEMAIL
    ----------------------------------------
    Officer(s) Subject to Allegation (Provide Whatever Info Is Known)





    ----------------------------------------

    Other Information

    How was this reported?
    In-PersonBy PhoneBy LetterBy EmailOther

    Any Physical Evidence Submitted?
    YesNo

    Was incident previously reported?
    YesNo

    ----------------------------------------

    To Be Completed by Officers Receiving Report

    Officer Receiving Complaint _________________________________ Badge No. ________

    Supervisor Reviewing Complaint ______________________________ Badge No. ________