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PAB Complaint Form
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Police Accountability Board (PAB) Complaint Form
This form is intended for use by those who wish to file a complaint against a UC Davis Police Officer(s) for misconduct and who seek formal investigation of the matter by the Office of Compliance and Policy. If you are not such a complainant and do not seek formal investigation, you may instead want to fill out the PAB's Suggestion/Awareness Form.
Complainant Information
Last Name
First Name
Mailing Address
Primary Phone Number
Alternative Phone Number
Email Address
Age
Gender
Race/Ethnicity
If you received any injuries as a result of this incident, please describe them here.
Incident Narrative
Date of Incident
Time of Incident
At which UC Davis location did the alleged violation occur?
--
UC Davis - main campus
UC Davis Medical Center
At or near what location on the campus did the alleged violation occur?
Please describe the incident that forms the basis of your complaint. It is important that you include a detailed factual description of the events that gave rise to your complaint.
Have you already spoken with a UCDPD supervisor about this incident?
Yes
No
If so, with whom did you speak?
Allegations
?
Allegations
Discourtesy
Abusive or obscene language, failure to provide information, failure to respond
Discrimination
Prejudicial treatment based on disability, gender, nationality, race or ethnicity, and/or religion
Harassment
Consistent, deliberate annoyance through repeated contacts
Improper Arrest
Improper Detention
Improper Police Procedures
Damage to, confiscation of , or failure to return property; failure to identify oneself or no badge visible, and/or making false statements
Improper Police Tow
Improper Search
Improper search of home, person, or vehicle
Improper Seizure
Improper seizure of person, property, or vehicle
Improper Use of Force
Improper physical contact; use of baton, firearm, handcuffs, mace, pepper spray, etc.; unnecessary display of firearm
Inadequate or Improper Investigation
Failure to investigate or make police report; false or improper police report
Other
Please specify below
Description of Other
Document
Document1
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256 MB limit.
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Document2
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256 MB limit.
Allowed types: pdf, doc, docx, jpg.
Document3
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One file only.
256 MB limit.
Allowed types: pdf, doc, docx, jpg.
Police Officer Information
Badge Information (if known)
Name of Police Officer (if known)
Gender of Police Officer
Identifying Characteristics of Police Officer (if badge number and/or name are not known)
Witness Information
Witness 1 Name (if applicable)
Witness 1 Address (if applicable)
Witness 1 Phone (if applicable)
Witness 1 Email (if applicable)
Witness 2 Name (if applicable)
Witness 2 Address (if applicable)
Witness 2 Phone (if applicable)
Witness 2 Email (if applicable)
Witness 3 Name (if applicable)
Witness 3 Address (if applicable)
Witness 3 Phone (if applicable)
Witness 3 Email (if applicable)
Certification
By checking this box, I am certifying that I understand the following information and the information I provided is true and correct to the best of my knowledge.
YOU HAVE THE RIGHT TO MAKE A COMPLAINT AGAINST A POLICE OFFICER FOR ANY IMPROPER POLICE CONDUCT. CALIFORNIA LAW REQUIRES THIS AGENCY TO HAVE A PROCEDURE TO INVESTIGATE CITIZENS' COMPLAINTS. YOU HAVE A RIGHT TO A WRITTEN DESCRIPTION OF THIS PROCEDURE. THIS AGENCY MAY FIND AFTER INVESTIGATION THAT THERE IS NOT ENOUGH EVIDENCE TO WARRANT ACTION ON YOUR COMPLAINT; EVEN IF THAT IS THE CASE, YOU HAVE THE RIGHT TO MAKE THE COMPLAINT AND HAVE IT INVESTIGATED IF YOU BELIEVE AN OFFICER BEHAVED IMPROPERLY. CITIZEN COMPLAINTS AND ANY REPORTS OR FINDINGS RELATING TO COMPLAINTS MUST BE RETAINED BY THIS AGENCY FOR AT LEAST FIVE YEARS.
