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Online Complaint Form

Please use this form if you wish to file an online Citizen's Complaint regarding an Independence Police Officer. Please fill in as much information as possible.

You may also download the Complaint Form, complete and mail to:

Attn: Capt. Thurman
Independence Police Department
223 N. Memorial Dr
Independence, MO 64050

Complaintant Information
Name:
Home Address:
Home Phone Number:
Business Address:
Business Phone Number:
Date of Birth: mm/dd/yyyy format

Complaint Information
Date of Incident: mm/dd/yyyy format
Time of Incident:
:
Location:
Name(s) of Officers or Employees Involved:   
  
Description:
(if name unknown)
Race:   Age:  
Height:   Weight: 
Sex: 
Clothing: 
Vehicle Number and/or Description:
Nature of Complaint:

Witness 1
Name:
Address:
Phone Number:

Witness 2
Name:
Address:
Phone Number:

Witness 3
Name:
Address:
Phone Number:

I do hereby affirm that the above information provided by me is true and complete to the best of my knowledge and belief. I understand that any false, misleading or untrue statements, accusations or allegation herein made by me in relation to this complaint, either orally or in writing, to any person or persons investigating this complaint may subject me to civil and/or criminal prosecution. I fully realize that it may become necessary in the investigation of this complaint for me to meet with a member or members of Independence Police Department to discuss this complaint. I agree that should any Administrative Hearing or Court proceedings result from the Investigation of my complaint, to make myself available to present testimony at such hearings if requested to do so.

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