City of Haverhill, Massachusetts

POLICE DEPARTMENT

Dedicated to Protect & Serve the Citizens of our Great Community

EMERGENCY: 911

City of Haverhill, Massachusetts

Dedicated to Protect & Serve the Citizens of our Great Community

EMERGENCY: 911

Home » Forms » Standardized Complaint Form

Standardized Complaint Form (SCF)

Please fill out the entire form to the best of your ability.

Form Instructions

Current Date:

Name:

Date of Birth:

Phone:

Email:

Address:

Bus Address:

Name:

Date of Birth:

Phone:

Address:

Date of Incident:

Time of Incident:

Employee (if known):

Action requested by complainant:

Officer receiving complaint:

Standard Complaint Narrative:

Signature of Complainant:

By checking this box, you agree to our Terms of Service.

You must agree to the Terms of Service before submitting your complaint.