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Complaint Against Employee


Individual Filing the Complaint


Injury Information
Doctor Information
Attorney Information

Witness Remove


Witness Information

Witness Relationship to Employee
Employee Name
Relationship to Employee

Witness

Employee Remove


Employee Information

Vehicle Information

Employee

Incident


Date of Incident
Incident Location

Attachment(s) supporting complaint:
File Name Created
No attachment available
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Complaint Against Employee Preview


Individual Filing the Complaint


Injury Information
Doctor Information
Attorney Information

Witness


Witness Information

Witness Relationship to Employee
Employee Name
Relationship To Employee

Employee


Employee Information

Vehicle Information

Incident


Date of Incident
Incident Location

Attachment(s) supporting complaint:
File Name Created
No attachment available

COMPLAINANT’S AFFIRMATION:
I DO SOLEMNLY SWEAR THE INFORMATION PROVIDED IS TRUE TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT BASED ON THIS COMPLAINT, AN INVESTIGATION WILL BE CONDUCTED AND THAT IF SUBSTANTIATED, APPROPRIATE ACTION MAY BE TAKEN. I FURTHER UNDERSTAND THAT IF THE INVESTIGATION PROVES THE ALLEGATIONS WERE KNOWN BY ME TO BE FALSE WHEN THE COMPLAINT WAS SIGNED, THE CASTLE ROCK POLICE DEPARTMENT MAY INITIATE APPROPRIATE LEGAL ACTION AGAINST ME FOR KNOWINGLY MAKING/GIVING FALSE INFORMATION, PURSUANT C.R.S. §18-8-111(1)(B).

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