E-Gov Services City of Carlsbad

WARNING! Please do not use this form to report issues of an emergency nature or for conditions requiring an immediate response. If your issue is an emergency, please use the telephone and dial 911.

Citizen Complaint To The Police

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Purpose. This form is used to communicate with city personnel to request services and request information.

* Information is required.

Contact Information

First Name:
Last Name:
Email:
Daytime Phone:	() –
Address:
City:
State:
ZIP:

* Describe the Incident

Please upload other Information Related to Incident

* Date of Incident *

* Name of the employee involved in the complaint.

* Time of Incident

* Were there witnesses to the incident?

Yes

Name of Witness

Witness Contact Info

* I hereby affirm that the facts described in the above complaint are true and correct to the best of my knowledge, and I understand that the effected employee(s) could bring civil action against me if my allegations are malicious. *

Yes

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Notes:

If you send us a message, you will receive a Tracking Number allowing you to follow-up with your request, at your convenience.

Internal Use Only, Leave Blank:
Please leave this field blank and remove any values that have been populated for it.