Citizen Complaint

Complaint Against Employee

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.

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

First Name

Middle Name

Last Name

Address

City

State

Zip

Home phone

Cell phone

Date of Birth

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

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

Date of Birth

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

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

Attachment(s) supporting complaint:

File Name	Created
No attachment available
		View

Complaint Against Employee Preview

Language

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

First Name

Middle Name

Last Name

Address

City

State

Zip

Home phone

Cell phone

Date of Birth

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

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

Date of Birth

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 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

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.

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GOVERNMENT CODE

Section 614.022. The complaint must be in writing and signed by the complainant

To be considered by the head of a state agency or by the chief of a fire or police department, the complaint must be:

(1) In writing; and

(2) Signed by the person filing the complaint.

Section 614.023. Copy of the complaint to give to the Officer or Employee

(a) A copy of a signed complaint against a law enforcement officer, firefighter, or police officer shall be served within a reasonable time after the complaint is filed.

(b) No disciplinary action may be taken against the officer or employee unless a copy of the signed complaint is served on the officer or employee.

PENAL CODE

Section 37.02. Perjury

(a) A person commits an offence if, with intent to deceive and with knowledge of the meaning of such statement:

(1) You make a false statement under oath or swear to the truth of a previously made false statement and the law requires or authorizes the statement to be made under oath; or

(2) Makes a false statement without oath under Chapter 132 of the Civil Practice and Remedies Code.

(b) An offense under this section is a Class A misdemeanor.

Section 37.03. Aggravated perjury

(a) A person commits an offence if he commits perjury as defined in Section 37.02, and the false statement:

(1) It is performed during or in connection with an official proceeding; and

(2) It is material.

(b) An offense under this section is a felony of the third degree.

Signature

Clear