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Citizen Complaint Form

  1. Complainant Information
    This form is to be completed by the person making the complaint.
  2. Officer(s) Involved (if known)
  3. Witness Information
  4. Incident Details
  5. I,
  6. Name of Complainant
  7. , hereby accuse
  8. Name(s) of Officer(s)
  9. if known, a member or employee of the Prescott Valley Police Department,

  10. of misconduct and/or improper procedure, the facts of which are set forth above. I formally request that the incident be investigated in accordance with the Prescott Valley Policies and Procedures. I understand that I may be required to give additional statements to investigators, attend public hearings of this matter and that my failure to do so will result in dismissal of this complaint. I understand that I may be asked to submit to a polygraph exam as a part of this investigation when necessary. I declare that the above statement is true and correct. I understand that giving a false statement, which is intended to mislead a public servant in the performance of his/her official function, is punishable under Arizona Law, ARS 13-2907.01.

  11. Leave This Blank:

  12. This field is not part of the form submission.