Citizen Complaint

Complaint Against Employee

The Citrus Heights Police Department welcomes justified complaints concerning the actions of our employees. As your Chief of Police, I want to assure you that this Department wishes to provide you with the best law enforcement service possible.

SUMMARY OF COMPLAINT PROCEDURE

Every person has an absolute right to file a complaint. Your reluctance to prepare a complaint form shall not impair that right. If you do not wish to complete the form or sign it, it shall be completed by the Watch Commander with whom the complaint is lodged. It is desirable that you come to the Police Department, where your complaint can be received during a personal interview. However, complaints can be made by mail or by telephone and may be made anonymously.

If the complaint is made by either telephone or mail, a copy of the complaint will be mailed to you if an address is provided. An investigator will contact all witnesses, examine any relevant physical evidence, and gather all information associated with each charge made in the complaint. After completion of the investigation, a disposition for each charge shall be made, based on each alleged act of misconduct.

The final disposition of your complaint will be made by the Chief of Police. Every investigator or supervisor assigned to investigate a personnel complaint or other alleged misconduct shall proceed with due diligence in an effort to complete the investigation within one year from the date of discovery by an individual authorized to initiate an investigation (Government Code § 3304). An extension may be granted by the Chief of Police if necessary. You will be notified of the extension and the reasons for that extension. You will be notified via mail or email of the disposition of the complaint.

Thank you for bringing this matter to our attention.

Sincerely,

* * * * * * * * * * * * * * * * * * * * * * * * * * * *

CAD Incident #

Complaint Type

Date of Complaint*

Time of Complaint*

Individual Filing the Complaint

Enter your personal information so we may contact you directly if our investigators have any additional questions and to notify you upon completion of our investigation.

You may remain anonymous by checking the appropriate checkbox if you wish, however, we will have no means to notify you of the outcome of the investigation. If you complete this form on behalf of another, please provide your information in addition to the individual's information on whose behalf you submitting this complaint.

Complainant is a minor/needs help.

Yes

Information of individual completing the form on behalf of another:

First Name

Middle Name

Last Name

Address

City

State

Zip

Home Phone

Cell Phone

Relationship to Complainant

I want to remain anonymous.

First Name

Middle Name

Last Name

Address

City

State

Zip

Home phone

Cell phone

Additional phone

Additional Email

Date of Birth

Age

Race

Gender

Driver’s License #

Disability

Type of Disability(s)

Best time to contact?

Primary Language Spoken

Are you able to communicate in English?

Arrested?

Citation Number

Injury Information

Was complainant injured during the incident?

Yes

Type of Injury

Severity of Injury

Did you seek medical attention?

Doctor Information

Doctor’s Name

Doctor’s Phone

Attorney Information

Attorney's Name

Attorney's Phone

Witness Remove

Enter any individuals that have or may have witnessed the incident.

Witness Information

First name

Middle name

Last name

Address

City

State

Zip

Home phone

Cell phone

Additional Phone #

Additional Email

Date of Birth

Age

Race

Gender

Driver’s License #

Relationship to Complainant

Witness Relationship to Employee

There are no Employee declared yet.

Employee Name

Relationship to Employee

Witness

Employee Remove

Please enter any information of the employee(s) who you are complaining on. if you do not know the involved employee's name or ID number, please describe them as best as possible as this will assist the Department in identifying the employee.

Employee Information

Employee #

First name

Middle name

Last name

Age

Race

Gender

In Uniform

Description of Employee

Vehicle Information

Vehicle Make

Vehicle Model

Vehicle Color

Vehicle Number

Vehicle Characteristics

Employee

Incident

Date of Incident

Day of Incident

Time of Incident

Incident Location

Address

City

State

Zip

Incident Description

Supporting Documentation

Attachment(s) supporting complaint:

File Name	Created
No attachment available
		View

Complaint Against Employee Preview

SUMMARY OF COMPLAINT PROCEDURE

Thank you for bringing this matter to our attention.

Sincerely,

* * * * * * * * * * * * * * * * * * * * * * * * * * * *

CAD Incident #

Complaint Type

Date of Complaint

Time of Complaint

Individual Filing the Complaint

Enter your personal information so we may contact you directly if our investigators have any additional questions and to notify you upon completion of our investigation.

Complainant is a minor/needs help.

Information of individual completing the form on behalf of another:

First Name

Middle Name

Last Name

Address

City

State

Zip

Home Phone

Cell Phone

Relationship to Complainant

I want to remain anonymous.

First Name

Middle Name

Last Name

Address

City

State

Zip

Home phone

Cell phone

Additional phone

Additional Email

Date of Birth

Age

Race

Gender

Driver’s License #

Disability

Type of Disability(s)

Best time to contact?

Primary Language Spoken

Are you able to communicate in English?

Arrested?

Citation Number

Injury Information

Was complainant injured during the incident?

Type of Injury

Severity of Injury

Did you seek medical attention?

Doctor Information

Doctor’s Name

Doctor’s Phone

Attorney Information

Attorney's Name

Attorney's Phone

Witness

Enter any individuals that have or may have witnessed the incident.

Witness Information

First name

Middle name

Last name

Address

City

State

Zip

Home phone

Cell phone

Additional Phone #

Additional Email

Date of Birth

Age

Race

Gender

Driver’s License #

Relationship to Complainant

Witness Relationship to Employee

There are no Employee declared yet.

Employee Name

Relationship To Employee

Employee

Employee Information

Employee #

First name

Middle name

Last name

Age

Race

Gender

In Uniform

Description of Employee

Vehicle Information

Vehicle Make

Vehicle Model

Vehicle Color

Vehicle Number

Vehicle Characteristics

Incident

Date of Incident

Day of Incident

Time of Incident

Incident Location

Address

City

State

Zip

Incident Description

Supporting Documentation

Attachment(s) supporting complaint:

File Name	Created
No attachment available

I have read and understood the above statement.

Signature

Clear