PARK SERVICE OFFICER COMPLAINT FORM

Please fill out this form completely. We cannot investigate unless you provide all the information requested below. Before submitting this form you must read and understand the process explained on the webpage.

Complainant Acknowledgement of 47.5 CA Civil Code and 148.6 CA Penal Code. “I have read, acknowledge and understand that knowingly making a false accusation against a peace officer is a violation of criminal and civil laws.” And that the accused peace officer may seek civil court actions against those who knowingly file a false accusation.

1

Your name (person filing complaint):

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Your name (person filing complaint):

2

Your date of birth (person filing complaint):

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Your date of birth (person filing complaint):

3

What is your gender? Male or Female?

What is your gender? Male or Female?

4

Date you submitted this complaint:

 *

Date you submitted this complaint:

5

Your phone number including area code:

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ext.Your phone number including area code:

6

Your Address. List Street, City, Zip Code:

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Your Address. List Street, City, Zip Code:

7

Best days/time for contacting you:

Best days/time for contacting you:

8

Location of incident:

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Location of incident:

9

Subject employee:

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Subject employee:

10

Complaint Details:

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Complaint Details:

11

If you have additional evidence, such as photos, videos, etc., please indicate the type of evidence and provide an unedited, complete copy with your complaint. Do you have additional evidence? Y/N?

Yes or No

12

Witness 1 Name, date of birth, Gender M/F, and phone number

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Witness 1 Name, date of birth, Gender M/F, and phone number

13

Witness 2Name, date of birth, Gender M/F, and phone number 

 *

Witness 2Name, date of birth, Gender M/F, and phone number

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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