Public Integrity Bureau
Complaint/Commendation Form

You are encouraged to print the following form and use it to submit any complaint you may wish to have the Public Integrity Bureau investigate. The form must be filled out completely and accurately. Your confidentiality will be respected, and P.I.B. will contact you should additional questions arise and/or to inform you of the results of the investigation.

1. ANY PERSON HAS A RIGHT TO FILE A COMPLAINT AGAINST ANY POLICE EMPLOYEE, WITHOUT FEAR OF RETALIATION, EVEN IF THAT PERSON HAS A PENDING CRIMINAL CHARCE.

2. THIS COMPLAINT FORM CAN BE PRINTED OR REPRODUCED. UPON COMPLETION YOU MAY  TAKE IT TO ANY POLICE STATION OR MAIL IT TO: COMMANDER, PUBLIC INTEGRITY BUREAU, 118 N. ROCHEBLAVE ST., NEW ORLEANS, LA 70119.

Print Form

TO: PUBLIC INTEGRITY BUREAU

SUBJECT: ALLEGED OR OBSERVED PERSONNEL MISCONDUCT

DATE: ________________

Complainant Name: __________________________________________

Social Security Number: ______________________________________

Race: ____________ Sex: __________ Date of Birth: _______________

Address: __________________________________________________

City: __________________ State: __________________ Zip: ________

Phone Numbers: Home ________________ Work _________________

Location of Incident: _________________________________________
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Date and Time of Incident: ____________________________________
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Description of Officer(s) or Employee(s): (examples: Name, Race, Sex, Badge#, Car#)

_________________________________________________________
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Witness Information: (Name, Address, and Telephone Numbers)

__________________________________________________________
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__________________________________________________________
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Incident: __________________________________________________
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Please use additional sheets of paper as necessary to provide complete information.

[Citizen Complaint Procedure] [Complaint Process] [Complaint/Commendation Form]