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Citizen Complaint Request Form

Your Complaint against our employee(s) is considered serious and will be actively pursued for any misconduct. For this reason, please ensure that your complaint is based upon fact and you have provided us with all of the facts to the best of your ability.

Enter the appropriate information in the fields below and click the "Send" button.

Date and Time Information:

Date of Report:

Address Where Incident Occurred:

Incident occurred between:

Start Date:		End Date:
	(MM/DD/YYYY)		(MM/DD/YYYY)

Start Time:		End Time:
	(HH:MM)		(HH:MM)
AM PM

Your Information:

First Name:

Last Name:

Home Address:

City:

Province:

Postal Code:

Home Phone:

Work Phone(optional):

Email Address:

Confirm Email:

DOB:
	(MM/DD/YYY)
Gender (optional): Male Female

Driver's License # (optional):

Province:

Please give a brief description of the incident: Include any information you may have concerning the identity of the involved member or members of the service.

I affirm that this information is true and correct
Your signature:

Please type your name as it appears above that this report is true and correct. By doing so you declare and affirm that your statement has been made by you voluntarily, without persuasion, coercion, or promise of any kind.

You should receive a confirmation e-mail of receipt of your complaint within 5 working days from submission. If you do not receive any confirmation or you have any further questions please contact the Winnipeg Police Service's Professional Standards Unit at 986-6079 Monday through Friday 7:00 a.m. to 4:00 p.m.

PRIVACY AND CONSENT

By sending this information, I consent to the City of Winnipeg using it as the City deems appropriate, including to respond to my message, to assist in providing me with the requested information or service, for general statistical purposes and/or in a police investigation.

Personal information will not be provided to any third party without your consent, except as may be required by law.