2. Instructions

   Please use this form to file a complaint or to compliment one of the employees of the Cabot Police Department.

4. Are you filing a complaint or a compliment?*

   1. Complaint

   1. Compliment
6. Please provide your identification and contact information below to help us address your compliment or complaint
8. First Name:*
9. Last Name:*
10. Phone:*
11. Alternate Phone:
13. Date of Birth:*

    MM/DD/YYYY

14. Sex:*
15. Race:*
17. Address:*
18. City:*
19. State:*
20. ZIP Code:*
24. Please provide information about the officer of employee. If you do not know their name, please provide a description
26. Employee Name:
27. Badge Number:
28. Second Employee Name:
29. Badge Number:
31. Vehicle license plate and/or vehicle number (if applicable):
32. Make and Model of Patrol Vehicle (if applicable):
34. Any Other Description:
36. Incident Date:*
37. Incident Location:*
38. Incident Time:
40. Did the incident involve an arrest or citation?*

    1. Yes
    2. No
41. If yes, please list the charge(s):
43. Witness Names(s), Address(es), Phone Number(s) if any:
45. Details of the event that caused you to bring this matter to our attention:*
47. 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.

    1. I agree.
49. Electronic Signature*
Leave This Blank:


51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit

* indicates a required field