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FILE A COMPLAINT
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FILE A COMPLAINT

Thank You for taking the time to stop by and submit your concerns regarding your interaction with our staff member(s). 
 
We feel that affording those we serve with the opportunity to connect with the police department online and relay their concerns / complaints is as important as patrolling and interacting face to face. Please provide us with as much information as possible to ensure we are able to review / investigate your complaint fully.

Complainant's Name:
Email Address:
Home Address:
Home Phone Number:
Cell Phone Number:
Business Address (if applicable):
Business Phone Number (if applicable):
Date of Birth:
Date of Incident:
Time of Incident:
Location of Incident:
Type of Incident:
Police Department Member(s) Involved (if known):
Member(s) Description(s) (if names not known):
Member(s) Badge Number(s) (if known):
Patrol Unit Number(s) / Description(s):
Nature of Complaint (Describe in Detail):
Witness #1 - Name:
Witness #1 - Address:
Witness #1 - Phone Number:
Witness #2 - Name:
Witness #2 - Address:
Witness #2 - Phone Number:
By checking this box, I acknowledge the below statement.
  

ACKNOWLEDGEMENT STATEMENT
 
I do hereby affirm that the above information provided by me is true and complete to the best of my knowledge and belief.  I understand that any false, misleading or untrue statements, accusations or allegation herein made by me in relation to this complaint, either orally or in writing, to any person or persons investigating this complaint may subject me to civil and/or criminal prosecution.
 
I fully realize that it may become necessary in the investigation of this complaint for me to meet with a member or members of Whitehall Police Department to discuss this complaint. I agree that should any Administrative Hearing or Court proceedings result from the Investigation of my complaint, to make myself available to present testimony at such hearings if requested to do so.
 
THOSE WHO SUBMIT IDENTIFICATION / INFORMATION FOUND TO BE FALSE WILL BE SUBJECT TO CIVIL / CRIMINAL PROSECUTION.
 
 
 
 

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Whitehall Police Department
57 Skenesborough Drive, Whitehall, NY 12887
Non-Emergency Phone (518)499-1316
Fax (518)499-3570
Emergency -  Dial 911
 
 
 

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