Citizen Complaint Form

Police Badge
600 East Walnut
Columbia, MO 65201-4491
573-874-7652/FAX: 573-874-3142

The mission of the
Police Department
is to reduce crime and improve public safety by enforcing the law, solving problems, providing crime prevention education and encouraging citizens to take responsibility for community safety and quality of life.

Columbia Police Department

Citizen Complaint Form

Complainant's Information

Name

Address

City

State

Zip Code

Home Phone

Cell Phone

Sex

Race

Age

Place of Work

Work Phone

Incident Details

Location Of Incident

Date

Time

Officers(s) Involved

Witnesses to the Incident (name, address, phone number)

Details of Incident (who, what, when, where, how, why) Include names and descriptions, times badges numbers, etc.)

Providing information about a complaint of action or inaction on the part of an employee of the Columbia police department constitutes a police report. The willful falsifying of information in a police report may be grounds for criminal violations or civil process by the employee accused.

I have read the above statement and by selecting submit I swear or affirm that it is true, I have also read and understand the advisory paragraph immediately above. Please verify entries before selecting submit.