Troy Police Department
Complaint Against Employee
Language
*
CAD Incident #
Date of Complaint
*
Time of Complaint
*
Individual Filing the Complaint
Complainant is a minor/needs help.
Yes
No
Information of individual completing the form on behalf of another:
First Name
Middle Name
Last Name
Address
City
State
Zip
Home Phone
Cell Phone
Email
Relationship to Complainant
I want to remain anonymous.
First Name
Middle Name
Last Name
Address
City
State
Zip
Home phone
Cell phone
Additional phone
Email
Additional Email
Date of Birth
Age
Race
Gender
Driver’s License #
Disability
Type of Disability(s)
Anxiety Disorder
Bi-Polar
Deaf
Depression
In Wheelchair
Missing Limbs
Mute
Other
Panic Disorder
Post-Traumatic Stress Disorder
Schizophrenia
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
No
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 #
Email
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
Division
Description of Employee
Vehicle Information
Vehicle Make
Vehicle Model
Vehicle Color
Vehicle Number
Vehicle Characteristics
Employee
Incident
Date of Incident
Date of Incident
Day of Incident
Time of Incident
Incident Location
Address
City
State
Zip
Incident Description
Supporting Documentation
Photo
Video
Attachment(s) supporting complaint:
File Name
Created
No attachment available
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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
Email
Relationship to Complainant
I want to remain anonymous.
First Name
Middle Name
Last Name
Address
City
State
Zip
Home phone
Cell phone
Additional phone
Email
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 #
Email
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
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
Division
Description of Employee
Vehicle Information
Vehicle Make
Vehicle Model
Vehicle Color
Vehicle Number
Vehicle Characteristics
Incident
Date of 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
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