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2. Please complete the online form below to submit your complaint.
4. Contact Information
6. First Name*
7. Last Name*
9. Address1*
11. Address2
13. City*
14. State*
15. Zip*
17. Home Phone Number*
18. Cell Phone Number
20. Daytime Phone Number
21. Email Address*
23. Drivers License #
24. DL State of Issue
25. Age
26. Sex
28. Employer / School
29. Phone Number
31. Address
32. City
33. State
34. Zipcode
36. Complaint Type*
    -- Select One --Procedural Use of ForceDemeanorOther
38. Complaint Against
39. Badge Number (if applicable)
41. Complaint Against
42. Badge Number (if applicable)
44. Date/Time Occured
    Date/Time Occured

    Date/Time Occured
45. Location
47. Date/Time Reported
    Date/Time Reported

    Date/Time Reported
48. How Reported
    -- Select One --In PersonMailPhoneOther
50. Details (if applicable, give description of injuries and treatment location)*
52. False Police Reports to a Law Enforcement Agency
    Anyone providing false information to a law enforcement agency can be charged under 718.6 of the Iowa Criminal Code
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54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit Submit and Print

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