HomeMy WebLinkAboutComplaint FormCOMPLAINT NO. HPC Date received:
Days from incident:
COUNTY OF HAWAII
POLICE COMMISSION
Aupuni Center
101 Pauahi St., Suite 9, Hilo, Hawaii 96720
Phone: (808) 932-2950
COMPLAINT OF MISCONDUCT AGAINST OFFICERS OR EMPLOYEES
The Police Commission investigates complaints of misconduct against officers or employees of the Hawaii
Police Department while on duty or acting under the color of authority. The complaint must be received
in the commission's office not more than 90 calendar days from the date of the incident.
PLEASE TYPE OR PRINT
NAME:
Mailing Address:
Date of Incident:
Birth Date: SS# last 4 digits:
Phone:
Time: Location:
ACCUSED OFFICER OR EMPLOYEE: (Name, badge number, or description if unknown.)
Name:
Name:
Name:
SUMMARY OF COMPLAINT: What is your complaint of misconduct against each officer or employee?
For example, the officer was discourteous while speaking to me. Summarize what happened.
HPCFORM 07-27-18 (TURN PAGE OVER TO CONTINUE, SIGN, AND NOTARIZE.)
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I have prepared this Complaint of Misconduct Against Officers or Employees of the Hawaii Police
Department and hereby certify that, to the best of my knowledge, and under penalty of perjury, that I was an
eyewitness to the events described in my complaint, and that the statements herein are true.
I understand that the Police Commission is not permitted to interfere in the administrative affairs of the Police
Department, and the commission will report its findings to the Chief of Police.
I further understand that the rules of the Police Commission prohibit the release of confidential records by the
Police Commission, except as authorized by HRS 92F.
COMPLAINANT'S SIGNATURE
PARENT OR GUARDIAN'S SIGNATURE
(If complainant is a juvenile.)
STATE OF HAWAII
COUNTY OF HAWAII
}SS
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}SS
Subscribed and sworn to me this
day of 120
Signature of Notary Public, State of Hawaii
Printed name of Notary Public
Judicial Circuit
My commission expires:
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