Complaint Form

The Ashby Police Department is mandated to investigate allegations of misconduct against employees of the Ashby Police Department. All allegations of employee misconduct are investigated by conducting a thorough and impartial examination of all available factual information.

Complaints against the Ashby Police Department or its members may be made by phone, letter, in person, or by filling out this form.

"*" indicates required fields

Name

First Last

Phone

Address

Street Address Address Line 2 City State ZIP Code

Incident Details

Time of Incident

Date of Incident

Police report Number

Location of Incident

Description of Incident*

Willing to Testify at a Hearing in Connection With This Complaint?*

I am willing to testify

I am NOT willing to testify

Officers Involved

Officers Name/Badge

Officer Description if Name Unknown

Officers Name/Badge

Officer Description if Name Unknown

Witness Infromation

Name of Witness #1

First Last

Phone

Witness Email

Address

Street Address Address Line 2 City State ZIP Code

Name of Witness #2

First Last

Phone

Address

Street Address Address Line 2 City State ZIP Code

Name of Witness #3

First Last

Phone

Address

Street Address Address Line 2 City State ZIP Code