patch and badge of the Brigham City Police Department

Brigham City Police Department Personnel Complaint Form

The Person Filing the Complaint

Fill out the following information about yourself, the person filing the complaint.

Business or School

Phone Number

Demographic Information

Sex

Race

Date of Birth

Is the person filing the complaint the same person reported as the victim of this complaint?

Yes

The Reported Victim of the Complaint

Fill out the following information about the person reported as the victim of this complaint.

Business or School

Phone Number

Sex

Race

Date of birth

Was this person arrested?

Yes

Attorney's Name

Attorney's Phone Number

Information About the Officer or Employee

Include any information you know about the officer or employee.

Rank or Position

Vehicle License Plate

Physical Description of Employee

Witnesses to the Incident

Include the names and contact information for any witnesses.

Witness #1 Phone Number

Witness #1 Email

Witness #2 Phone Number

Witness #2 Email

Witness #3 Phone Number

Witness #3 Email

Details of the Complaint

Date and Time of Incident

Location of Incident

Case Number, if known

Include as many factual details as possible.

Attach any images or photographs

Click Here to Upload

Legal Advisement and Acknowledgment

*** READ BEFORE SIGNING ***

You have the right to make a complaint against a police officer for any improper police conduct. Utah law requires this agency to have a procedure to investigate citizens' complaints. You have the right to a written description of this procedure.

A person is guilty of a Class B Misdemeanor if he or she knowingly makes a written false statement (UCA 76-8-504) or knowingly gives false information to any law enforcement officer with the purpose of inducing an orricer to believe another has committed an offense (76-8-506).

I HAVE READ AND UNDERSTAND THE ABOVE STATEMENT, AND I CERTIFY THAT THE INFORMATION CONTAINED IN THIS COMPLAINT IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE (TO INCLUDE ANY ATTACHMENTS).

Sign Here. If under 18 years of age, a parent or guardian must sign.

First Name

Last Name

Choose how to sign

Draw Type