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Personnel Complaint Form

Citizen Complaint Form

Complainant Information



Date of Birth: 



Reason for Complaint

Date of Incident: 



Name of Officer(s): 

Officer(s) Bage/ID Numbers: 

I want to complain because:


Additional Witnesses (List names, addresses, phone numbers, and any other pertinent information.  If no witnesses, put "No witnesses")


You have the right to make a complaint against a police officer for any improper police conduct.  California Law requires this agency have a procedure ro investigate citizens' complaints.  You have a right to a written description of this procedure.  This agency may find after investigation that there is not enough evidence to warrant action on your complaint;  Even if that is the case, you have the right to make the complaint and have it investigated if you believe an officer behaved improperly.  Citizen complaints and any reports or findings relating to complaints must be retained by this agency for at least five years.

                    I have read and understood the above statement


Once submitted, your complaint will be sent to the Escalon Police Department for investigation.  You will be contacted by an Internal Affairs Investigator who will have you sign a copy of your complaint.  If you are under the age of 18 years old, a parent or guardian will be required to sign a copy of the complaint as well.

                       Complainant is 18 years old or older: Yes    No


Complainant Name: 

Parent/Guardian Name (Under 18): 


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