City of Springfield Police Complaint Form | City of Springfield Ohio Official Website

Please complete the following form to report a complaint with the City of Springfield Police. This report will be sent to the City Manager's Office and a representative will reach out to you with next steps if necessary.

Your Information

Complaintant's Name(Required)

First Middle Initial Last

Date of Birth

Gender

Race or Ethnicity

Home Address

Street Address Address Line 2 City ZIP Code

Home Telephone Number

Cell Number

Email Address

Alternate Contact Information

Incident Information

Date of Incident

Day of the Week

Time of Incident

:

Location of Incident

Police Vehicle No./Description:

Officers Involved (name, badge number)

Physical Description of Officer(s)

(hair and eye color, height, sex, race/ethnicity, etc.)

Describe Injuries (if any)

Where were you treated? (name of hospital, doctor, etc.)

Name(s), telephone number(s), or contact information for other people present during the incident (including other police officers)

Preferred language of communication:

English

Spanish

Haitian Creole

Other

Describe the Incident(Required)

Complaintant's Certification:(Required)

I hereby certify that, to the best of my knowledge, the statements herein are true. I acknowledge that making of false statements is punishable by criminal penalties.

Today's Date(Required)

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