Citizen Feedback Form

The Fort Pierce Police Department values feedback from the community. If you wish to commend an employee for exemplary service or file a complaint regarding the conduct of a staff member, we encourage you to complete this Citizen Feedback form. Please provide detailed information to ensure we fully understand your experience and are able to address the matter appropriately.

CommendationComplaint

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Officer’s Name(s) (if known)

Incident Date

Date

Time

Incident Location

Brief Description*

PLEASE NOTE: You have the right to file a complaint against a police officer or any Department employee if you believe they have engaged in improper conduct, and to have that complaint thoroughly investigated. The Police Department treats all allegations of employee misconduct with the utmost seriousness.

Please be advised, however, that if an investigation determines a complaint was made maliciously, in bad faith, or with knowledge that the allegation was false, the Department may pursue legal action, when possible, against the complainant for filing a false report.

During the course of the investigation, you may be asked to provide a recorded and sworn statement to ensure a fair and accurate review of the matter.

I HEREBY CERTIFY, UNDER THE PENALTY OF PERJURY, THAT THE INFORMATION I PROVIDED IS TRUE AND CORRECT.

Printed Name*

Date*

Date

Signature*