LAPEER COUNTY SHERIFF'S OFFICE
CITIZEN COMPLAINT FORM
Today's Date:
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Complainant's Name
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Prefix
First
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Last
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Suffix
Your Address
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Street Address
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Address Line 2
City
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State / Province / Region
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Postal / Zip Code
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Country
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Your Email
Phone Number
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Cell Phone Number
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Best way of contacting you?
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Email
Home Phone
CellPhone
Complaint Information
Date and Time Occurred
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MM
AM
PM
AM/PM
Location
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Complaint
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In your own words, please describe you complaint and alleged actions of the Deputy in question. Please list any witnesses that may have been present.
READ STATEMENT BELOW CAREFULLY BEFORE SUBMITING YOUR COMPLAINT
The complaint as stated above is in my own words and details my personal experince with and/or observationof the inident reported. As the LapeerCounty Sheriff's Department takes these matters very seriously, I understand that any untrue statements intentionly made could result in civil action being taken against me.