Edit Form DATE OF INCIDENT* Date Received Time Received OCA Number CAD Number Supervisor Receiving Complaint General Information Continued In-Person Mail Telephone Third Person Anonymous Complainant Information Full Name* Race* Sex* Date of Birth* Home Address? Day Telephone Evening Telephone Other Number Identification of Accused Employee(s) Name* ID# Race Sex Unit assigned Identification of Accused Employee Name ID# Race Sex Unit assigned Identification of Accused Employee Name ID# Race Sex Unit assigned Witness Information Name Day Telephone Evening Telephone Co-complainant Yes No Witness Information Name Day Telephone Evening Telephone Co-complainant Yes No Details of Complaint* The undersigned hereby certifies that the information contained in this complaint is true and complete to the best of my knowledge and belief. I understand that making a false report to a law enforcement agency is a violation of North Carolina law and may subject me to criminal prosecution and/or civil liability. My signature below acknowledges that I have received a photocopy of this complaint report and that I have been informed of the complaint processing procedure. Signature of Complainant* Date* Placing your name in the signature block has the same effect as signing your name in pen on a written document * Check to Agree* I Agree × Share this page Copy and paste this code into your website. <a href="http://www.thomasville-nc.gov/departments/police/file_a_complaint.php">Your Link Name</a> Share this page on your favorite Social network Facebook Twitter Reddit Close