Internal Affairs Complaint Form

You must fill out this form in its entirety. Any false information submitted will not be processed.
Contact Information
Enter your first name.
Enter your last name.
Enter your address
Enter your city.
Select your state.
Enter your zip code.
Enter your phone number.
Complaint Information
Enter the case number related to this incident if applicable.
Select the date this incident occurred. Use MM/DD/YYYY format.
Enter the time this incident occurred. Use H:MM AM|PM format.
Enter the location where this incident occurred.
Please explain your complaint in detail.
Witness Information
Enter the name of your witness
Enter the phone number of your witness.
Enter the address of your witness.
Enter the name of your witness.
Enter the phone number of your witness.
Enter the address of your witness.
Employee/Deputy Information
Enter the first name of the employee/deputy.
Enter the last name of the employee/deputy.
Enter the deputy's badge number.
Select yes or no.
Select marked or unmarked.
Submission & Legality
Florida State Statute 837.06 states whoever knowingly makes a false statement in writing with the intent to mislead a public servant in the performance of his or her official duty shall be guilty of a misdemeanor of the second degree, punishable as provided in section 775.082 or section 775.083 Further, if the charges are found to be unfounded or exonerated, the accused has the right to pursue civil recourse against the complainant. When an internal investigation is concluded, that investigative file becomes open for personal inspection by any person pursuant to Florida Statute Chapter 119.
Signature & Affirmation
Check yes if you acknowledge the information submitted is true and accurate.
Enter your name to digitally sign this complaint.