Full Text
Belgrade Police Department Complaint and Commendation Form I WANT TO FILE A: COMPLAINT COMMENDATION SUPERVISOR CONTACT REQUEST Date: INFORMATION ABOUT YOU: Name: Date of Birth: Address: Home: ( ) Work: ( ) Cell: ( ) E-mail: INFORMATION ABOUT THE INCIDENT: Date: Time: AM PM Address/Location: INFORMATION ABOUT THE BELGRADE POLICE DEPARTMENT OFFICER(S) OR EMPLOYEE(S) INVOLVED: Name: Badge Number: Name: Badge Number: INFORMATION ABOUT A WITNESS (continue on reverse side; attach additional pages or documents if needed): Name: Phone: ( ) Address: NATURE OF COMPLAINT OR COMMENDATION OR REASON FOR SUPERVISOR CONTACT (continue on reverse side; attach additional pages or documents if needed): KNOWINGLY MAKING A FALSE STATEMENT AGAINST AN OFFICER IS ILLEGAL You have the right to file a complaint; however, it is against the law pursuant to MCA 45-7-205 for an individual to file a report based on false information. SIGNATURE: DATE: ---PAGE BREAK--- (DEPARTMENT USE ONLY BELOW THIS LINE) REPORT RECEIVED BY: INVESTIGATIVE DISPOSITION OF COMMENDATION / COMPLAINT □ Court Issue □ Commendation – place in personnel file □ Resolved with citizen/no further action necessary □ Complaint – Forward for Investigation □ Referred □ Unfounded □ □ Supervisor contact made SIGNATURE OF SUPERVISOR: SIGNATURE OF CHIEF OF POLICE/DEPUTY CHIEF OF POLICE/CAPTAIN: