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 OFBIRTH: __________________________________
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 Agencythe information
below for statistical purposes to include in its reports to the Federal Monitor and CityCouncil.
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 formand any other documentation you provide will be forwarded to the Civilian
Police Oversight Agency's Executive Director. The Executive Director andthe CPOA staff will fully
and independently investigate the Complaint. The Executive Director willpresent recommended
findings to the PoliceOversight Board. The Boardwill make findings and may propose discipline. It
will then submit the completed investigationand findings to the Chief of Policefor review and
consideration for possible discipline.
STATEMENT
• I
t isimportant toprovideasmuchinformationas
possible
• Please
describethe incident andthespecific nature ofyour complaint ascompletelyas
possible.
•
Include thenames, addressesand phonenumbers ofanywitnesses.
•
Beasspecific aboutthedetails, suchasexactly what was
said,timeand dates of incident, thelocationof
theincident, the APDofficers/employees involved,ifknown.
•
If
officer(s)'s namesarenotknown, please include detailed
descriptionsofofficers.
•
Attach additionalsheets, andincludeany other relevantitems(
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 deliverto: 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
