Fillable Printable Civilian Police Complaint Form - New Mexico
Fillable Printable Civilian Police Complaint Form - New Mexico
Civilian Police Complaint Form - New Mexico
Official Use Only
Date/Time Received: ______________________
Received by: ________________________
CPC #: ________________________
Assigned to:_____________________________
CIVILIAN POLICE COMPLAINT FORM
For complaints against the Albuquerque Police Department
COMPLAINANT INFORMATION
Complaints may be submitted anonymously or on behalf of another person. If you do not give your name, it
may be more difficult to fully investigate the case. If you file a complaint, it is unlawful and against APD
Policies for anyone to retaliate against you for the filing of this complaint.
NAME: ______________________________________________________________________
(FIRST) (MIDDLE) (LAST)
ADDRESS: ___________________________________________________________________
(STREET NAME AND NUMBER)
_______________________________________________________________________________________________________
(CITY) (STATE) (ZIP CODE)
DATE OF BIRTH: __________________________________
TELEPHONE: Home: ________________________ Cell/Work: _________________________
EMAIL: _____________________________________________________________________________
Date and Time of Incident: _______________________________________________________________
Address where incident happened: _________________________________________________________
Names and Badge Numbers of Officer(s) (if known): __________________________________________
Would you be interested in mediation to resolve this complaint? Yes ☐ No☐
Optional: The DOJ and City Council request you give the Civilian Police Oversight Agency the information
below for statistical purposes to include in its reports to the Federal Monitor and City Council.
GENDER: Male ☐ Female☐ Transgender ☐
SEXUAL ORIENTATION: Heterosexual ☐ Homosexual ☐ Bi-Sexual ☐ Asexual ☐
RACE: African-American ☐ Native American ☐ Hispanic ☐
Caucasian ☐ Asian ☐ Other ☐ _____________
Do you suffer from Mental Illness? Yes ☐ No ☐
Do you struggle with Homelessness? Yes ☐ No ☐
Is English your primary language? Yes ☐ No ☐
This complaint form and any other documentation you provide will be forwarded to the Civilian
Police Oversight Agency's Executive Director. The Executive Director and the CPOA staff will fully
and independently investigate the Complaint. The Executive Director will present recommended
findings to the Police Oversight Board. The Board will make findings and may propose discipline. It
will then submit the completed investigation and findings to the Chief of Police for review and
consideration for possible discipline.
STATEMENT
• I
t is important to provide as much information as
possible
• Please
describe the incident and the specific nature of your complaint as completely as
possible.
•
Include the names, addresses and phone numbers of any witnesses.
•
Be as specific about the details, such as exactly what was
said, time and dates of incident, the location of
the incident, the APD officers/employees involved, if known.
•
If
officer(s)'s names are not known, please include detailed
descriptions of officers.
•
Attach additional sheets, and include any other relevant items (
photos, witness statements, etc.)
The information provided in this statement is true and factual to the best of my knowledge. I understand I
may be required to appear in the Civilian Police Oversight Agency Office for an interview or to provide
other investigative assistance, as necessary.
__________________________________________
Complainant’s Signature/Date
Questions? Civilian Police Oversight Agency (CPOA) Telephone (505) 924-3770; Website: www.cabq.gov/CPOA
Mail your complaint to:
Civilian Police Oversight Agency (CPOA), City of ABQ, P.O. Box 1293, Albuquerque, NM 87103
-or-
Hand deliver to: CPOA at 600 2nd ST. NW, Room 813, Albuquerque, NM 87102
-or- Any APD Substation -or- APD Internal Affairs Division, City Hall, One Civic Plaza
Revised 4/20/15-DOJ Compliant
