Internal Affairs Unit Incident Form

You have the right to file an allegation regarding any conduct by a member of the San Jose Police Department with the Internal Affairs Unit or the Independent Police Auditor. You are entitled to a copy of your statement at the time you file the allegation. The Internal Affairs Unit will conduct an investigation into the allegation. After the complaint investigation is completed, the Department may take some form of personnel action against the accused officer if it determines that misconduct occurred or it may find that there is insufficient evidence to warrant personnel action against the officer. A written notice of the disposition of the allegation will be provided within 30 days of the Department's finding. Personnel complaints will be retained for at least five years. Policy complaints are not considered to be personnel complaints. Non-Misconduct Concerns are not considered to be complaints.

The San Jose Police Department has a strict policy which prohibits the retaliation against complainants and/or witnesses.

Your Information

Today's Date

MonthDayYear

Last Name

First Name

Middle Name

Address

City

State

Zip

Mailing Address (if different from above)

City

State

Zip

Home Phone

Work Phone

Mobile Phone

E-mail Address

Date of Birth

MonthDayYear

Gender

Ethnicity

Information about the Incident

Date of Incident

MonthDayYear

Time of Incident

Police Report Number (if known)

Location of Incident

Do you know the Officer's Name(s) involved in this incident?

Officer #1 Name and Badge Number

Officer #2 Name and Badge Number

If the officer's name is unknown, please provide a badge number or physical description:

Do you have names of any witnesses and their contact information?

Witness #1 Name, Address, Phone Number

Witness #2 Name, Address, Phone Number

Summary of the Incident

0/10000

Do you wish to take a photo or upload an existing image?

Select "Take a Photo" or "Upload Existing"

*Note: Rotating your phone after clicking “Take Photo” will clear all entered data. Please keep your phone in one orientation.

Take Photo

Upload a Photo

Browse Files

jpg, jpeg, png, gif

Does your complaint involve biased based policing based on the following criteria: race or ethnicity (including color), nationality, age, religion, gender, gender expression, sexual orientation, mental disability, or physical disability? (Explain in summary below.)

Bias Criteria

Select the form of bias that affected your complaint.

Why do you believe your complaint involves biased based policing related to Race or Ethnicity?