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This form is to be completed by the person making the complaint.
Name of Complainant
, hereby accuse
Name(s) of Officer(s)
of the Prescott Valley Police Department,
of misconduct and/or improper procedure, the facts of which are set forth above. I formally request that the incident be investigated in accordance with the Prescott Valley policies and procedures. I understand that I may be asked to participate further in the investigative and administrative processes to ensure due process for all involved. I declare that the above statement is true and correct. I understand that giving a false statement, which is intended to mislead a public servant in the performance of his/her official function, is punishable under Arizona Law, ARS-13-2907.01.
This field is not part of the form submission.
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