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2. Date & Time of Report
   Date & Time of Report

   Date & Time of Report
4. Location of Incident
6. Officer/s Involved
8. Date & Time of Incident
   Date & Time of Incident

   Date & Time of Incident
10. Complainant's Name
11. Birthdate
    Birthdate
13. Address
14. Phone Number
16. Witness Name
17. Birthdate
    Birthdate
19. Address
20. Phone Number
22. Additional Witnesses
24. Additional Information
26. Does this complaint involve racial profiling?

    1. Yes
    2. No
28. Does this complaint involve identity profiling? (If yes, please explain in the following summary.)

    1. Yes
    2. No
30. Summary of Complaint
32. The Citizens’ complaint process is designed to investigate the allegations of citizens and to make a determination of fact as to any wrongdoing. In cases where a false complaint is maliciously filed against a peace officer, that officer is entitled to file a civil action. Therefore, it is important all allegations presented in a complaint to the Department be based on factual information.
    
    Penal code Section 148.6 requires that all law enforcement agencies accepting an allegation of misconduct against a peace officer shall require the complainant to read and sign the following information advisory.
    
    YOU HAVE THE RIGHT TO MAKE A COMPLAINT AGAINST A POLICE OFFICER FOR ANY IMPROPER POLICE CONDUCT. CALIFORNIA LAW REQUIRES THIS AGENCY TO HAVE A PROCEDURE TO INVESTIGATE CITIZEN’S COMPLAINTS. YOU HAVE A RIGHT TO A WRITTEN DESCRIPTION OF THIS PROCEDURE. THIS AGENCY MAY FIND AFTER INVESTIGATION THAT THERE IS NOT ENOUGH EVIDENCE TO WARRANT ACTION ON YOUR COMPLAINT; EVEN IF THAT IS THE CASE, YOU HAVE THE RIGHT TO MAKE THE COMPLAINT AND HAVE IT INVESTIGATED IF YOU BELIEVE AN OFFICER BEHAVED IMPROPERLY. CITIZEN COMPLAINTS AND ANY REPORTS OR FINDINGS RELATING TO COMPLAINTS MUST BE RETAINED BY THIS AGENCY FOR AT LEAST FIVE YEARS.
    
    IT IS AGAINST THE LAW TO MAKE A COMPLAINT THAT YOU KNOW TO BE FALSE. IF YOU MAKE A COMPLAINT AGAINST AN OFFICER KNOWING THAT IT IS FALSE, YOU CAN BE PROSECUTED ON A MISDEMEANOR CHARGE.
    
    I have read and understood the above statement.
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34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

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