Please provide as much information as possible about the action. This form is transmitted directly to the Office of Internal Affairs.

About You

Name (Last, First MI)

Address

City, State, ZIP

Telephone

Best Number to Contact You

Best Times to Contact You

Other Telephone Number

E-mail

About the Incident

Date of occurrence

Approximate time(s) of occurrence

Location of occurrence

Officer(s) involved

If you do not know the officer's name, please provide a description of the officer(s) in the narrative section below.

Describe What Happened

Explain what happened from your point of view. Please provide as much detail as possible.

Personal Injury

Were you injured in the incident? Yes No

Did you seek medical attention? Yes No

Please describe your injuries in the box below. If you sought medical attention, list the name of the doctor who treated you.

Witnesses

If there were any witnesses to this event, please provide information on how we may contact them.

Witness #1:

Witness #2:

Witness #3:

Outcome

What would you like to see happen as a resolution in this matter?

Certification

The Office of Internal Affairs exists to address citizen complaints and concerns with the actions of members of the Boise Police Department.  In this way, we can serve to forge a better bond between Boise Police officers and the citizens they serve.  However, frivolous or malicious complaints do nothing to enhance this bond.  Therefore, complainants must provide truthful and accurate information to the best of their ability. By checking the following box, you certify that the information provided is truthful and accurate.

I certify that the foregoing information I truthful and accurate to the best of my knowledge.