2. The professional standards function is important for the maintenance of professional conduct of the Derby Police Department. The integrity of the department depends on the integrity and discipline of employees. It is the policy of the Derby Police Department to investigate any charge of misconduct of its members. Fill out the Citizen Complaint Form as completely and accurately as possible. If you have not been contacted within seven days of filing your complaint contact Lt. Brandon Russell at (316) 788-3093 to check the status of the complaint.
4. Name
5. Date of Birth
6. Sex (M/F)
8. Address
9. City
10. State
12. Phone Number
13. Email
15. Occupation
17. Name of Alleged Victim of Incident (if other than you, the complainant)
19. Address
20. Phone Number
22. Name of Attorney/Person Assisting Complainant
24. Address
25. Phone Number
27. Name of Witness
29. Address
30. Phone Number
32. Name of Witness
34. Address
35. Phone Number
37. Name of Witness
39. Address
40. Phone Number
42. Name(s) of Officer(s) Complaint Against
44. If name is unknown, please describe the officer(s) and when and where the incident took place
46. Please describe in detail what took place during the incident.
48. Your Electronic Signature*
    Type your name
49. Date
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51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit

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