Citizen Inquiry/Complaint Form

As a government agency charged with protecting the public and enforcing the law, the Perry Police Department strives to provide the highest level of customer service possible. We value the opinion of the public we serve in order to help us achieve this standard. By providing your input - positive or negative - we can learn where our efforts are hitting the mark and where we might need to focus our attention to improve the service we provide to the many residents and visitors we encounter each year.

Perry Police Department Citizen Inquiry / Complaint Form
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Perry Police Department Citizen Inquiry / Complaint Form

* Indicates required field

Complainant's Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

Date of Birth *

Gender *

Female Male Non-Binary

Date of Incident *

Time of Incident *

Arrested? *

No Yes

Case Number *

Location of Incident *

Police Department Staff Involved *

Other Agency Staff Involved *

Complaint Details (Please be sure to give detailed explanation) *

Complainant Signature *

A person who reports or causes to be reported false information, knowing the information is false, or who reports the alleged occurrence of a criminal act knowing the act did not occur, commits a misdemeanor. An officer shall have the right to pursue civil remedies under the law against a citizen arising from the filing of a false complaint against the officer. *

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Citizen Inquiry/Complaint Form​

Perry Police Department Citizen Inquiry / Complaint Form

Citizen Inquiry/Complaint Form