DALLAS POLICE DEPARTMENT OFFICER COMPLAINT

This complaint is filed under the Tex. Gov. Code Title 6 Subchapter B, Sec. 614.002(2) and
614.021(3), where the complaint applies only to a peace officer employed by a municipality
with a population over 50,000 or more, and that peace officer under Article 2.12, Code of
Criminal Procedure, or other law who is appointed or employed by a political subdivision of this
state. Sec. 614.022(1)(2) requires the complaint to be considered by the head of a state agency
or by the head of a local law enforcement agency. This complaint is to be considered under
special circumstances due to the nature of the criminal misconduct alleged, shows good cause in
the complainant declaration below, and was submitted to the Dallas Police Department located at
Internal Affairs Division, 1400 S. Lamar Street, Dallas, Texas 75215:
COMPLAINANT DECLARATION
I, ____________________________________ DECLARE I HAVE A COMPLAINT
AGAINST

DALLAS POLICE OFFICER; ___________________________________________________

OFFICE BADGE NUMBER (IF KNOWN): ________________________________________
DATE OF INCIDENT/COMPLAINT:

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Dallas Communities Organizing for Change Police Officer Complaint Form

DESCRIPTION OF COMPLAINT
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Dallas Communities Organizing for Change Police Officer Complaint Form

I CERTIFY THAT I HAVE READ THIS COMPLAINT, I FULLY UNDERSTAND ITS

CONTENTS, AND I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF
THE STATE OF TEXAS THAT THE FOREGOING STATEMENTS AND PHOTOCOPIES
OF ATTAFCHED DOCUMENTS ARE TRUE AND CORRECT TO MY KNOWLEDGE.

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SIGNATURE

Before me the undersigned authority, on the ______ day of __________, 20____, personally
appeared, _________________________________, known to me to be the person whose name
is subscribed hereto, and being duly sworn stated that he/she has personal knowledge of the facts
hereinabove and that such facts are true and correct.

___________________________________________
Notary Public

DALLAS COUNTY, TEXAS

MY COMMISSION EXPIRES:

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Dallas Communities Organizing for Change Police Officer Complaint Form