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  West Palm Beach Police Department 600 Banyan Blvd West Palm Beach, Florida 33401 : : : Phone: 561.822.1600 : : :
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 CITIZEN COMPLAINT AND INQUIRY FORM  





As a citizen, you are encouraged to contact the Police Department if you have a complaint about the actions of a police officer or non-sworn employee if you believe their conduct was inappropriate or that they have violated the law. The staff of the Internal Affairs Unit can answer questions about actions of officers, initiate a complaint against an officer, and conduct investigations of police conduct. Although we encourage citizens to report police misconduct, complaints must be made in good faith. False or highly exaggerated complaints serve no good purpose for either the citizens or the officer.

Name of Complainant:  

Addresss of Complainant: 


Home Phone: 

Work Phone: 

Pager: 

Cell Phone: 

E-Mail Address: 

Date of Incident: (mm/dd/yyyy) 

Time:  (Note whether a.m. or p.m.) 

Location:  

Case Number:   #160;if applicable

Name of Involved Employee(s) and ID#(s)

Employee Name:  

ID#:  

Employee Name:  

ID#:  

Complainant's Comments

Complainant's Signature:  
Not necessary if submitting through e-mail


Note: You do not need to fill in the following fields. Click on "Submit" at the bottom of this form to send. Thank You.

Supervisor Receiving Initial Information:  

ID#:  

Supervisor's Signature:  

Date:  



Summary of Inquiry
Disposition of Complaint or Inquiry
Court Issue

Resolved with Citizen and/or No Further Action Deemed Necessary

Formal Complaint

Statement of Complaint mailed off

Statement of Complaint hand delivered

Statement of Complaint E-mailed

Investigative Comments




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