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Legal Advisement and Acknowledgment(Required)
You have the right to make a complaint against a police officer for any improper police conduct. Utah 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 behaves improperly.
Additional Note:(Required)
• If this is an emergency call 911
• If police action or investigation is necessary for the item you are commenting on, please contact dispatch so that an officer can assist you properly and in a timely manner

Reporting Person's Information

MM slash DD slash YYYY
Sex
MM slash DD slash YYYY
Reporting Person's Name
Residence Address

Victim's Information

Victim same as above?
Victim's Name
MM slash DD slash YYYY
Victim Sex
Victim Arrested?
Victim Address

Employees & Others Involved

Name of West Jordan Employee(s) if Known
Name of Witness(es)
Witness Address

Incident Information

MM slash DD slash YYYY
Time of Incident
:
It is important to include as many factual details as possible, so that the incident may be fully investigated.
Details of files/photographs or information to be included
Name/Signature
Please elaborate on which symptoms you are experiencing.