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I Would Like to File a Complaint on an Employee
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What is Your First Name?
What is Your Last Name?
What is your home address? (House Number, Street, City, State Zip)
What is the best way to contact you? By phone or email? Please provide your contact information.
If you know the employees name please type here:
If don't know the employees name, please describe each employee involved.
How did you come into contact with the employee?
What was the date of this incident?
What time did this happen?
What was the address or location of the incident? Please be specific.
Please give a detailed description of what happened.
Was there anyone with you during the incident?
If someone was with you please provide their name, address, and phone number(s)
I understand that I may be asked to give a sworn written affidavit to proceed with this complaint.
I am willing to cooperate with the investigation
I am not willing to provide a sworn written statement
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