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Complaint No. HPC Date Received: <br />POLICE COMMISSION <br />COUNTY OF HAWAII <br />Aupuni Center <br />101 Pauahi St., Suite 9, Hilo, Hawaii 96720 <br />Phone: (808) 932-2950 Fax: (808) 932 -2949 <br />COMPLAINT OF MISCONDUCT BROUGHT BY THE PUBLIC <br />The Police Commission investigates complaints of misconduct against officers or employees of the police <br />department while on duty or acting under the color of authority. The complaint must be received in the <br />commission's office within 60 days of the incident. A request for an exception to the 60 -day rule must be in <br />writing with an explanation for the delay. <br />PLEASE TYPE OR PRINT <br />NAME: Birth Date: SS# last 4 digits: <br />Mailing Address: Phone: <br />Date of Incident: Time: Location: <br />ACCUSED: (Name, badge number, or description if unknown.) <br />Name: <br />Name: <br />Name: <br />SUMMARY OF COMPLAINT: Describe in detail the incident that led to this complaint. <br />What is your specific complaint against each person? How could it be resolved to your satisfaction? <br />Fill out form HPCHEALTH for release of your medical records of injuries sustained. <br />Rev. 01 -07 -10 (TURN PAGE OVER TO SIGN & NOTARIZE COMPLAINT.) <br />Page 1 <br />