Citizen Complaint

The Eastern Illinois University Police Department recognizes the need for the filing of legitimate complaints against officers as a means by which they can be held accountable to the public; however, the Department will also seek to hold members of the public responsible for the filing of false allegations against police officers. In the event your complaint gives rise to formal disciplinary action against one of our officers, you will be required to sign a sworn affidavit specifically alleging in the officer's misconduct.

Information
Name Name * First Last
Date of Birth Date of Birth * / MM / DD YYYY
File # *
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone * - ### - ### ####
Email *
Witness Information
Witness #1 Name Witness #1 Name First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Witness #2 Name Witness #2 Name First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Officer Information
Officer #1 Officer #1 First Last
Badge #
Officer #2 Officer #2 First Last
Badge #
Nature of Complaint *
Location of Incident *
Date Date * / MM / DD YYYY
Time Time * : HH MM AM/PM
Complainant's Signature.
Draw your signature into the box below. *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date * / MM / DD YYYY
Time Time * : HH MM AM/PM
Accepting Supervisor's Signature.
Draw your signature into the box below. *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / MM / DD YYYY
Time Time : HH MM AM/PM

Citizen Complaint

Citizen Complaint

Information

Witness Information

Officer Information