Bremerton Police Department
Complaint Against Employee
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Language
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CAD Incident #
Complaint Type
Disability Discrimination
Other ADA Complaint
Other Auxiliary Aids and Services Unavailable
Sign Language Interpreter Unavailable
Arrest Review
Biased Based Policing Complaint
Civilian Complaint
Department Vehicle Accident Review
Firearm Discharge
Performance Review
Rules and Regulations
Supervisor Complaint
Courtesy
Demeanor
Didn't agree with Traffic Ticket
Dissatisfied with handling of call, investigation, or report
Failure to Arrest
Harassment
Racial Discrimination
Rudeness
Search and Seizure
Traffic Violations
Unlawful Arrest
Use of Force
Vehicle Use by Officer
Date of Complaint
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Time of Complaint
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Individual Filing the Complaint
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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
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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
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Employee Information
Employee #
First name
Middle name
Last name
Age
Race
Gender
In Uniform
Division
Section
Unit
Description of Employee
Vehicle Information
Vehicle Make
Vehicle Model
Vehicle Color
Vehicle Number
Vehicle Characteristics
Employee
Incident
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Date of Incident
Date of Incident
Day of Incident
Time of Incident
Incident Location
Address
City
State
Zip
Incident Description
Supporting Documentation
Photo
Video
Audio
Attachment(s) supporting complaint:
File Name
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Complaint Against Employee Preview
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Language
CAD Incident #
Complaint Type
Date of Complaint
Time of Complaint
Individual Filing the Complaint
Please enter Instruction here
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
Please enter Instruction here
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 Instruction here
Employee Information
Employee #
First name
Middle name
Last name
Age
Race
Gender
In Uniform
Division
Section
Unit
Description of Employee
Vehicle Information
Vehicle Make
Vehicle Model
Vehicle Color
Vehicle Number
Vehicle Characteristics
Incident
Please enter Instruction here
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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