"To Protect & Serve"

Paterson Police Department

Paterson Police Raise $33,000 for Children's Cancer Research and Care


Paterson Police

Division ____________________________________________________________________                         IAD# _________________________________________________________________

                                                                        部门/机构                                                                                   IA案件编号

内部事务举报表

举报人(选填,但为有用信息)



 全名



地址(公寓编号)

 


市、州、邮编

 


 

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______________________________________________________

 

 

电话

 

 

电子邮箱

 

 

出生日期

 

首选?

________________________________ 

 

 

________________________________ 

 

 

________________________________ 

受指控之官员(提供任何已知信息)

 

官员姓名

 

事件地点

 

 

_____________________________________________ 

 

____________________________________________________

 

工牌编号

 

日期/时间

 

 

___________________________________ 

 

___________________________________ 

在下方空白处详述事件的类型(交通中断、街头遭遇)以及关于所指控之行为的任何信息。如果下方空白处的空间不够,您可以另附纸页来书写您的答案。如果您不知道官员的姓名或工牌编号,请提供任何其他身份识别信息。

其他信息

 

举报是如何进行的?     当面     通过电话     通过信函     通过电子邮件     其他 _____________________________

 

是否提交了任何物证?               如果是,请详述: ___________________________________________________________

 

之前是否举报过该事件?               如果是,请详述: _________________________________________________________

 

由接收举报的官员填写

________________________________________________________________                              _______________               _______________

Officer Receiving Complaint                                                                                                                       Badge #                        Date/Time

接收投诉的官员                                                                                                                                              工牌编号                        日期/时间

______________________________________________________________________                     _______________           _______________

Supervisor Reviewing Complaint                                                                                                                Badge #                        Date/Time

复核投诉的主管                                                                                                                                              工牌编号                        日期/时间