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Police Complaint Form

  • Contact Information

  • Incident Information

  • MM slash DD slash YYYY
  • :

  • Name of officer(s) against whom complaint is being filed, or other identifying marks (car number, badge number, etc.)

  • Name(s) / Address / Phone number or other identifying information concerning witnesses:
  • I understand that this statement of complaint will be submitted to the Steelton Police Department and may be the basis for an investigation. Further, I sincerely and truly declare and affirm that the facts contained herein are complete, accurate,; and true to the best of my knowledge and belief. Further, I declare and affirm that my statement has been made by me voluntarily, without persuasion, coercion, or promise of any kind.

  • Notice:

  • I understand that, under the regulations of the police department, the officer against whom this complaint is filed, will be entiiled to requesting and receiving .a copy of this complaint. In addition, said officer may be entitled to a hearing before a board of inquiry. In addition I understand that my statements can be used in any civil proceedings brought on the part of the officer against whom this complaint is· filed. By submitting and filing this complaint, I hereby agree to appear before a board of inquiry, or grievance board, if one is requested by an officer, and to testify under oath concerning all matters relevant to this complaint.