3. 
6. Baton Rouge City Police Department
8.  Complaint Form

10. If you have a complaint against an employee of the Baton Rouge Police Department, please fill out this form.
    

    You may also write a letter of complaint to the Chief of Police.
    Submit your letter to the following address below:

    • Contact Us: 225-389-3802
    • Police Department
    • 9000 Airline Highway
    • Baton Rouge LA 70815
12. Date*
    Date

    Date
13. I.A. or File#
15.  Your Information
17. Your Name
18. Phone Number
19. Email
21. Address
23. City
24. State
25. Zip Code
27.  Incident Information
29. Date and Time of Incident
    Date and Time of Incident

    Date and Time of Incident
30. Complaint Against an Employee

    1. Use of Force
    2. Unprofessional
    3. Racial Profiling
    4. Other
32. List other type of complaint here.
34. Describe the Incident*
36. Description of Officer(s) or Employee(s)*
38. Additional Witness Information*
40. I, the undersigned, do hereby desire to file an official complaint*
42. Describe the Incident (Upload Documents/Pictures/Videos)
    txt, pdf, doc, docx, gif, jpg, png, avi, mov, mp3, mp4, wav files only; 14 MB max

44. I fully understand that by signing this affidavit, I will be required to appear at and testify if necessary, at any administrative hearing to which I am subpoenaed. I agree to return to testify when noticed, and I realize that by failing to do so will result in this complaint being terminated.

    
    

    I agree to furnish at my own expense, any medical records or documents which the Internal Affairs Investigation may request of me in regard to this complaint. I understand that I have ten (10) working days from the date on this form to furnish the Internal Affairs Investigators with said records, or my complaint may be terminated due to lack of cooperation on my part.

    
    

    I fully understand that it is incumbent upon me to produce any witnesses for an interview by the Internal Affairs Investigators, within ten (10) working days from the date of this form.

    
    

    I certify that I have read this form and understand it in full and that all of the information that I have given or will give to the Internal Affairs Investigators is true and correct to the best of my knowledge.

46. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
48. Electronic Signature
Leave This Blank:


50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit Submit and Print

* indicates a required field