THIS FORM IS PROVIDED BY THE ACLU OF WISCONSIN. PLEASE READ ALL INSTRUCTIONS THOROUGHLY.
MILWAUKEE POLICE HARASSMENT QUESTIONNAIRE
If you believe that you have been stopped and/or frisked, when walking or driving, for no good reason or have otherwise had your civil rights violated during a traffic and/or pedestrian stop by MILWAUKEE POLICE since 2011, the ACLU wants to hear from you. Please fill in your information below.

If you believe you have you been stopped and/or frisked, when walking or driving, by a law enforcement agency OTHER THAN MILWAUKEE POLICE (such as the Milwaukee County Sheriff's Office, Wisconsin State Patrol, or another municipality such as the Wauwatosa or Green Bay Police Departments)
please DO NOT report those incidents on this page. Please click here instead: https://aclu-wi.org/case-questionaire-form

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ESPAÑOL:

Si crees que has sido detenido y registrado o tus libertades civiles han sido violadas durante una parada de tráfico o peatonal por el Departamento de Policía de Milwaukee, la Unión de Libertades Civiles (ACLU) lo quiere saber. Por favor llena esta forma con tu información.

Si crees que has sido detenido y registrado por una agencia de la ley aparte del Departamento de Policía de Milwaukee, haz clic aquí: https://aclu-wi.org/case-questionaire-form

American Civil Liberties Union of Wisconsin
What's your first and last name?
¿Cuál es tu nombre y apellido?
Your answer
How old are you?
¿Cuántos años tienes?
Your answer
What is your email address?
¿Cuál es tu dirección de correo electrónico?
Your answer
What is the primary phone number we can always reach you at? (Including your area code)
¿Cuál es tu número de teléfono primario? Incluye tu código de área.
Your answer
Is there an alternate number to reach you if the one above is inactive?
¿Tienes algún número de teléfono adicional?
Your answer
What is your current address? (e.g. 124 n. 56th St, Milwaukee, WI 53201)
¿Cuál es tu domicilio principal?
Your answer
What is your gender?
¿Cuál es el género con el que te identificas?
What is your racial background?
¿Con cual raza te identificas?
Required
Have you been harassed by Milwaukee Police within the last 6 months?
En los pasados seis meses, ¿sientes que has sido acosado/a por el Departamento de Policía de Milwaukee?
Have you been harassed by Milwaukee Police since 2008?
Desde el 2008, ¿sientes que has sido acosado/a por el Departamento de Policía de Milwaukee?
Please give us a short summary of your encounter(s) with Milwaukee Police including exact or approximate dates, times, and description of the officers. (e.g. #1. Sept 1st 2017 at 7pm. I was walking... #2. Sept 2nd 2017 at 7am. Officer Jones..Badge#, Car#.. I was driving #3. Sept 3rd 2017 I was...etc.)
Describe tu encuentro con la policía de Milwaukee, incluyendo días y horas exactas o aproximadas, y una descripción de los oficiales de policía involucrados, incluyendo detalles como el nombre y numero de placa del oficial.
Your answer
PLEASE MAKE SURE THAT YOU CLICK THE 'SUBMIT' BUTTON BELOW OR YOUR COMPLAINT WILL NOT BE RECORDED!
Cuando termines, asegúrate de oprimir el botón de “SUBMIT” o tu queja no se procesara.
Submit
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