Misd Police Department Citizen Complaint Form
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1
2Mansfield ISD Police Department
Office of Internal Affairs
1522 N. Walnut Creek Dr.
Mansfield, Texas 76063
(817) 299-6000
MISD Police Department
Citizen Complaint Form
(To Be Completed by Person Registering Complaint)
Complainant Name:
Race/Sex:
Date of Birth:
Address:
City/ST/Zip:
Best Contact Number to Call:
Best Time to Call:
Email Address:
(
) -
-
Ext:
WITNESS INFORMATION
Name:
Address:
Phone#:
Name
Address:
Phone #
Name:
Address:
Phone#:
Name
Address:
Phone #
OFFICER/EMPLOYEE INFORMATION
Name:
Badge/ID#
Car#
Name
Badge/ID#
Car#
Name:
Badge/ID#
Car#
Name
Badge/ID#
Car#
INCIDENT DETAILS
Date of Incident:
Time of Incident:
Police Report# (if known):
Location of Incident:
NARRATIVE
(Please Print Synopsis of Complaint)
(Continue in shaded area on other page)
(04/2015)
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Parent category: Legal