CITIZEN COMmendation/COMPLAINT REPORT

The Culpeper County Sheriff's Office is committed to the prompt and fair resolution of complaints concerning the actions and performance of our personnel. As an organization, we strive to provide the highest level of law enforcement services all citizens.

Policing is a difficult and complex job in today's society. We realize mistakes can be made and the actions of our personnel may at times fall short of your expectations.

I hereby certify that the information contained in this report is true, accurate, and complete to the best of my knowledge:

Submitter Information:

Name

First Name

Last Name

Phone

(###)

###

####

Address

Involved Sheriff's Office Employee:

Name

First Name

Last Name

Badge Number

(if applicable)

Assignment

Witness Information:

Name

First Name

Last Name

Phone

(###)

###

####

Address

Incident Details

Date of Incident

YYYY

Time of Incident

Hour

Minute

Second

Location of Incident

Details of Incident

I do hereby affirm that the 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 allegations 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 a civil suit and/or criminal prosecution

CITIZEN COMmendation/COMPLAINT REPORT

14023 Public Safety Ct, Culpeper, VA 22701