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2. 

3. Hampton Police Department
   Commendation / Complaint Form
   100 Brown Avenue
   Hampton, New Hampshire 03842
   Phone (603) 929-4444
   http://www.hamptonpd.com/

5. Instructions: If you would like to praise a Hampton Police Department employee, or file a complaint against a police employee, please write legibly and fill out this form. Personal information will not be disclosed to the public, unless required by law. You can submit this form by mailing or returning it to the Hampton Police Department at the address given at the top of this page.

7. I wish to file a:

   1. Commendation
   2. Complaint
8. Type of Complaint

   1. Formal Complaint: Involves a serious allegation of misconduct, and I want my complaint officially investigated, for which discipline may be imposed, if the allegation(s) are sustained.
   2. Informal Complaint: Involves a minor complaint or concern, and I only want my complaint/concerns on record. I understand it will be for informational purposes only, will not be formally investigated.

10. Information about you

12. First Name
13. Last Name
15. Date of Birth
16. Gender

    1. Male
    2. Female
17. Email Address
19. Address
20. Apartment/Suite
22. City
23. State
24. Zip Code
26. Phone Number
27. Cell Phone/Work Number
29. Are you filing this on behalf of someone else?

    1. Yes
    2. No
31. If Yes, then complete this section. If No, then proceed to incident information
33. His/Her Name
34. His/Her Date of Birth or Age
36. Address
38. City
39. State
40. Zip Code
42. Phone Number
43. Cell Phone/Work Number
45. Email Address
46. Gender

    1. Male
    2. Female

48. Information about the incident

50. Location or Address of Incident
51. Date/Time of Incident
    Date/Time of Incident

    Date/Time of Incident
53. Witness First Name
54. Witness Last Name
56. Witness Address
58. City
59. State
60. Zip Code
62. Witness Phone Number
63. Witness Cell Phone/Work Number
65. Witness Email Address
67. Subject Officer #1 Name or ID Number
69. Subject Officer #2 Name or ID Number
71. Nature of action: Check all that apply and briefly describe what happened on a separate sheet of paper (date & sign it)

    1. Extremely helpful
    2. Very caring/empathetic
    3. Professional conduct
    4. Did a great job
    5. Made an extra effort

    1. Excessive and/or improper use of force
    2. False arrest
    3. Unlawful search and/or seizure
    4. Dishonesty and untruthfulness
    5. Corruption

    1. Rudeness, discourtesy, and offensive language
    2. Violation of civil rights
    3. Bias-based profiling
    4. Department procedures or tactics
    5. Other
73. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. I attest that the above information and my statement is true and correct to the best of my recollection

    1. I agree.
75. Electronic Signature
76. Date
    Date
Leave This Blank:


78. 1. Receive an email copy of this form.
79. Email address

    This field is not part of the form submission.

80. Submit Submit and Print

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