Citizen Complaint Form Against Employee

2. Aventura Police Case or Citation Number

3. Date of Incident
   Date of Incident

4. Time of Incident
   Time of Incident

6. Location of Incident

8. Address

10. City

11. State

12. Zip Code

14. Conduct Allegation

15. Name of Person Making Complaint

17. Contact Information

19. Address

21. City

22. State

23. Zip Code

25. Phone Number

26. Alternate Phone Number

28. Witness to Incident
    Witness to Incident: If there is more than one witness, please include their names and contact info into the explanation field.

    Witness to Incident: If there is more than one witness, please include their names and contact info into the explanation field.

30. Address

32. City

33. State

34. Zip Code

36. Phone Number

37. Alternate Phone Number

39. Employees Involved

41. Employee 1

43. Name

44. Position

45. ID Number

47. Employee 2

49. Name

50. Position

51. ID Number

53. Specifics of Complaint

55. You will be contacted by mail regarding this submission within 48 business hours. Call Internal Affairs to verify receipt of your submission at 305-466-8989, ext. 8147.

    You will be contacted by mail regarding this submission within 48 business hours. Call Internal Affairs to verify receipt of your submission at 305-466-8989, ext. 8147.

57. Staff Use Only

59. Received by

60. Date Received
    Date Received

61. Assigned to for Investigation

63. Date Due Back

64. Assigned by

65. Date Assigned

67. The assigned investigator/supervisor is required to send a weekly update of the status of the investigations to I.A. Extensions beyond the due date must be approved by the appropriate Division Commander.

    The assigned investigator/supervisor is required to send a weekly update of the status of the investigations to I.A. Extensions beyond the due date must be approved by the appropriate Division Commander.

Leave This Blank:


68. 1. Receive an email copy of this form.
69. Email address

    This field is not part of the form submission.

70. Submit

* indicates a required field