Citizen Complaint Form


Complete this form if you wish to file a complaint about a Springfield Police Department employee. Please read Complaints of Police Misconduct before completing this form.

*Required Fields

Name of Complainant (last, first, middle) 
Name of Person Filing Report if Different
(last, first, middle) 
Sex  Male Female
Date of Birth 
Street Address 
Zip Code 
Home Phone (include area code) 
Work Phone (include area code) 
E-mail Address  
Involved Employee(s) (if known) 
SPD Case Number (if known) 
Location of Incident 
Date of Incident 
Time of Incident
Witness Name, Address, Phone 
Witness Name, Address, Phone 
Describe in detail what happened.  
How would you like to see this 
complaint resolved? 
By typing my name in the space below, I hereby certify that the statements given by me herein are true and accurate to the best of my personal knowledge. I understand that making intentional false declarations to public servants or untrue statements under oath or affirmation may be punishable by law.
Name of Complainant*:  Date*: