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By submitting this form you agree to the information provided being used for case management and any other policing purpose including Home Office Statistics and assessment.

1. Complainant details

Please provide your personal details.
Complainant name

2. Equality of service monitoring form

The Police Service is committed to providing Equality of Service in terms of dealing with members of the public regardless of race, gender, marital status, colour, nationality, religion or belief, ethnic or national origin, sexual orientation, age or disability. This commitment applies to all issues in relation to dealing with members of the public. In order that we may monitor and maintain Equality of Service we would like you to answer some additional questions. However, if you would prefer not to say it will not affect your complaint in any way.

3. Complainant contact details

Please provide your contact details. If you would like to receive a copy of your complaint by email, please enter your email address below.
Complainant address

4. Agent details

Details of anyone (family member, friend or solicitor) who is acting on your behalf.

Please provide details about the agent below

Address
Please tick here to confirm the complainant authorises you to act on their behalf / you authorise the complainant to act on your behalf. We will require written authority before we can proceed. 

Please continue to section 4

5. Details of your complaint

Please provide details of your complaint.

6. What is your complaint about?

Please describe the circumstances that have led to your complaint. Include details of:
  • Who was involved? 
  • If there was any damage or injury
  • What was said and done?
  • Summary of your complaint

7. Complaint resolution

Please describe your expected resolution to the complaint below (what you would like to happen).

8. Complaint circumstances

If your complaint relates to discrimination, please tick if it refers to any of the following:

9. Members of the police service subject of complaint.

Please provide details of any members of the police service relating to your complaint

Person 1

Person 2

Person 3

Person 4

Person 5

Person 6

If you need to add any further information you can do so using the free text box in section 10.

10. Witnesses to the incident

Please provide any information about witnesses to the incident.

Witness details 1

Witness address

Witness details 2

Witness address

11. Additional Information

Please use this section for any other relevant information.
Include any special requirements or additional support needed in dealing with your complaint.

12. Confirmation

Please tick the box below to proceed.
Please tick here to confirm that the above information is truthful and accurate to the best of your knowledge