Citizen Complaint

Complaint Against Employee

The El Cerrito Police Department has procedures to receive, review, and investigate allegationsof employee misconduct. The Department promptly assesses all complaints and assigns them for investigation. The assigned investigator interviews involved parties, examines evidence, and prepares a written investigative report. The Police Captain reviews the report and forwards it to the Chief of Police for final determination. The Department notifies the complainant of the disposition in writing.

Language*

CAD Incident #

Date of Complaint*

Time of Complaint*

Individual Filing the Complaint

Please enter your personal information so we may contact you directly should our investigators have any additional questions. Additionally, this will be used to notify you upon completion of our investigation.

You may remain anonymous by checking the appropriate checkbox. 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 are 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

Gender

Driver’s License #

Type of Disability(s)

Best time to contact?

Primary Language Spoken

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

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 regarding the employee(s) whom you are complaining about. 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

Race

Gender

In Uniform

Description of Employee

Vehicle Information

Vehicle Number

Employee

Incident

You have the right to make a complaint against an employee of the El Cerrito Police Department. A complaint may be made in person, by telephone, by mail, or by a person not directly involved in the incident.

Please provide a detailed description of the incident including the date, time, and location.

*By submitting this form, the Complainant acknowledges and certifies that the information contained in this complaint is true and correct to the best of their knowledge and belief.*

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

Language

CAD Incident #

Date of Complaint

Time of Complaint

Individual Filing the Complaint

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

Gender

Driver’s License #

Type of Disability(s)

Best time to contact?

Primary Language Spoken

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

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

Race

Gender

In Uniform

Description of Employee

Vehicle Information

Vehicle Number

Incident

Please provide a detailed description of the incident including the date, time, and location.

*By submitting this form, the Complainant acknowledges and certifies that the information contained in this complaint is true and correct to the best of their knowledge and belief.*

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 confirm that I have read understood the "Electronic Record and Signature Disclosure" and consent to use electronic records and signatures.

Signature

Clear