Sunday, October 22,2017 10:26 PM

UPPER SECTION TO BE COMPLETED BY POLICE

Year
IOP#
Submitted By#
District/Unit Preparing
CC#
Event#
Report Date
Date and time notified
Rank
ID#
Person Notified(I.A)

COMPLAINANT'S INFORMATION

First Name
Last Name
Initial
Address
City
State
Age
Race
Sex
Date of Birth
Occupation
Home Phone
Bussiness Phone

NAME OF ALLEGED VICTIMS OF INCIDENT IF OTHER THAN COMPLAINANT

Victims Name
Address
Home Phone
Bus. Phone

NAME(S) OF OTHER WITNESSES

Last Name First Name Initial Address Phone Action
Please click here to Add Witness Details

NAMES OF OFFICER(S) COMPLAINED AGAINST (IF KNOWN)

Name Rank Badge District/
Unit
Assign
ment
Height Weight Hair Eyes Sex Age Race Other Action
Please click here to Add Officers Details
IN DETAIL STATE WHAT OCCURRED:
Office of Professional Standards

494 Broad Street, 1st floor
Newark, NJ 07102
(973) 733-6171
(973) 424-0163


Professional Standards Navigation Menu

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