City of Haverhill, Massachusetts

POLICE DEPARTMENT

Dedicated to Protect & Serve the Citizens of our Great Community

EMERGENCY: 911

City of Haverhill, Massachusetts

Dedicated to Protect & Serve the Citizens of our Great Community

EMERGENCY: 911

Home » Forms » Standardized Complaint Form

Standardized Complaint Form (SCF)

Please fill out the entire form to the best of your ability.

Form Instructions

Current Date:

Name:

Date of Birth:

Phone:

Email:

Address:

Bus Address:

Name:

Date of Birth:

Phone:

Address:

Date of Incident:

Time of Incident:

Employee (if known):

Action requested by complainant:

Officer receiving complaint:

Standard Complaint Narrative:

Signature of Complainant:

By checking this box, you agree that the above is true and accurate to the best of my knowledge.

You must check the box agreeing, form is true and accurate to the best of my knowledge before submitting your complaint.