LEO MISCONDUCT COMMUNITY COMPLAINT FORM

INSTRUCTIONS FOR COMPLETING THIS FORM: Please describe the incident that led to this complaint, telling what happened from beginning to end. Be as clear and specific as you can be. What aspect(s) of the incident was improper (your specific complaint).

Please also view the follow link for more information
HOW TO Fight Back Against LAW ENFORCEMENT Terror in SD COUNTY
http://uaptsd.org/2014/12/25/how-to-fight-back-against-police-terror-in-your-area-psa/

COMPLAINANT NAME

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ADDRESS

(optional, will remain confidential at all times)

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HOME PHONE

(will remain confidential at all times)

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BUS. PHONE

(will remain confidential at all times)

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CITY

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STATE

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ZIP

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DOB

Gender/ Gender Identity/Gender Expression

(optional to help identify unjust profiling trends by LEO)

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Race/Ethnicity

(optional to help identify unjust profiling trends by LEO)

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INCIDENT LOCATION:

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INCIDENT DATE

INCIDENT TIME

INCIDENT TIME DURATION

: :

Officer(s) Information

(please include; Names, Race, Badge No. & ID No. Ie. "Officer Smith, White, Badge No.1234, ID No.3456")

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INCIDENT DESCRIPTION/COMPLAINT:

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WITNESSES

(please include; Names & relation to complainant Ie. "John Smith, Father"

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Do you have video footage, photographs or any other supporting documentation?

Please email Uaptsd@gmail.com the supporting information

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