Citizens Commendations/Complaints | Constable Precinct 4

Commendation or Complaint Form

Are you submitting a commendation or a complaint? *

Commendation

Complaint

Select one of the options above to see the next set of form fields.

Questions indicated with an * (asterisk) are required.

General Information

First Name: *

50 characters max

Last Name: *

50 characters max

Address: *

Enter your Block Number and Street Name. 100 characters max

Address Line 2:

Enter your Apartment, Suite, or P.O. Box Number. 100 characters max

City: *

60 characters max

State *

Zip: *

5 digits max

Date of Birth: *

Please enter a date in this format: .

Driver License #:

25 characters max

DL State

Email: *

100 characters max

Home Phone:

10 digits max

Cell Phone:

10 digits max

Work Phone:

10 digits max

Preferred Method of Contact: *

Incident Information

Incident Date: *

Please enter a date in this format: .

Incident Time: *

Location: *

100 characters max

Case # (if known):

100 characters max

Employee Name (if known):

50 characters max

Acknowledgement

I understand that I may be required to appear in person for the purpose of being interviewed and/or to complete a sworn statement if the matter referenced above involves a complaint on an employee.

I Agree *

Signature *

50 characters max

Date