Commendation-Complaint Form – Stephens County Sheriffs Office

Select Type of Form

Commendation
Complaint

Name *

First

Middle

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email

Date of Birth

Who is the Complaint Against?

Employee Name *

First

Last

Employee Name *

First

Last

Date / Time of Complaint *

Date

Time

Today’s Date & Time

Date / Time of Report *

Date

Time

Today’s Date & Time

Date / Time of Incident *

Date

Time

On what Date and Time did the Incident occur?

Date / Time of Incident *

Date

Time

On what Date and Time did the Employee do something Commendable?

Nature of Complaint *

Please describe, in detail, the incident in concern.

Commendation Statement *

Please describe, in detail, what the Employee did that was Commendable?

Printed Name *

Please type your name to affirm that you understand that this is an official document of the Stephens County Sheriff’s Office and that it will be used to determine whether and employee is guilty of misconduct, unprofessional behavior, or criminal activity. Also that by typing you name above, you are verifying that you have carefully read this document, filled out all requested information and that all the information you have entered is true. YOU ALSO UNDERSTAND THAT IT WOULD BE A FELONY TO KNOWINGLY MAKE ANY FALSE STATEMENT ON THIS FORM AND THAT IF YOU MAKE ANY FALSE STATEMENT YOU WOULD BE SUBJECT TO CRIMINAL PROSECUTION UNDER THE LAWS OF THIS STATE, INCLUDING BUT NOT LIMITED TO O.C.G.A 16-10-20.

Printed Name *

Please type your name, or “Anonymous”, before pressing Submit below.

Custom Captcha *

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