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Police 131444

Online complaint

NOTE: All fields marked with an asterisk are mandatory.

YOUR PARTICULARS
*Surname *First Name Middle Name
Age Occupation Ethnicity
*Home Address *Email
*Please enter at least one contact phone number below
Phone Home Phone Work Mobile
Preferred time to contact you hrs *Preferred phone contact number
Are you making this complaint on behalf of another? (If No, go to Subject Officer/s)
*Reason why (Parent, Legal practitioner, Doctor, complainant does not speak english, witness etc)
CONTACT DETAILS OF THIS OTHER PERSON
Surname First Name Middle Name
Home Address Email
Phone Home Phone Work Mobile
SUBJECT OFFICER/S (IF KNOWN)
Name 1 Rank Number Station
Name 2 Rank Number Station
Name 3 Rank Number Station
Police vehicle registration and type (caged van, sedan, highway patrol etc)
INCIDENT DETAILS
*Date and time of incident (if not specifically known approximate)
*Place description of incident (e.g. Police Station, lockup, hotel, club, park)
*Location description (e.g. street) *Suburb
Infringement Number Incident Report Number
Witness Phone Number Address
Witness Phone Number Address
Witness Phone Number Address
Do you have other evidence or documents to support your complaint? (e.g. Video records, audio recordings, photos, medical reports)
ALLEGATION DETAILS
*Nature of allegation (rudeness / manner / conduct / excessive use of force / service delivery / unlawful conduct etc)
1.
2.
3.
*Details of allegation or complaint (limit 10,000 characters)
*What outcomes are you expecting to see or believe would be appropriate? (e.g. explanation, apology, officer spoken to etc)
Have you previously complained to the police, the corruption and crime commission, the ombudsman, minister for police or other agency about this matter? (If No, go to Complainant Information)
  Date Reference Number
COMPLAINANT INFORMATION

Complaints made about WA Police employees are subject to external review or audit by the Corruption and Crime Commission (CCC).

Should you not be satisfied with the outcome or the manner in which your complaint was handled you can raise your concerns with the CCC who may take further action or refer the matter back to police for consideration of further investigation.

The Corruption and Crime Commission can be contacted by calling 92154888 or by email info@ccc.wa.gov.au or www.ccc.wa.gov.au or in writing to PO Box 7667 Cloisters Square St Georges Tce, Perth WA.

*****WARNING*****

Making a false complaint or creating a false belief may be an offence under the Criminal Code or the Corruption and Crime Commission Act.

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