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Citizen Complaint Form

  1. This form is to be completed by the person making the complaint.

  2. I,

  3. Name of Complainant

  4. , hereby accuse

  5. Name(s) of Officer(s)

  6. of the Prescott Valley Police Department,

  7. 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.

  8. Leave This Blank:

  9. This field is not part of the form submission.