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City Marshal and Park Ranger Conduct Report Form

Type of report*
Incident number
If you received a citation, fill in this box with your citation number.
Person Reporting
Complete this section with your information.
Name*
First and last name.
Email Address
Address
City
State
Zip Code
Phone Number*
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Witness Information
Were there any witnesses? Complete the information below with the contact information for witnesses. If not, proceed to the next section.
Witness #1
Name
Email Address
Address
City
State
Zip Code
Phone Number
Witness #2
Name
Email Address
Address
City
State
Zip Code
Phone Number
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Information About Occurrence
Date and Time of Occurrence*
Date and Time of Occurrence
Date and Time of Occurrence
Location Name*
What is the name of the location where this occurred?
Location Address*
Name of Officer or Employee *
What is the name of the officer or employee involved? If name is unknown, provide a short description.
Incident Description*
Include a detailed description of the incident, circumstances, or conduct that you wish to report.
In the event that the information you provide is in regard to an allegation of wrongful conduct on the part of a police employee, please read and sign below: Citizen's Statement: I believe that the facts I have provided are true and correct to the best of my knowledge. I agree to present this complaint in person to the appropriate investigative authority should the complaint result in a disciplinary proceeding against the officer(s) or other police employee(s). By typing your name below, you are signing that you agree to the above statements.
Under penalty of perjury, I affirm that the information I am submitting is true and accurate to the best of my understanding.*
First Name*
Last Name*
Today's Date*
Today's Date
Today's Date

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