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Information about you

Last Name:

First Name: Middle Initial

Birthdate:

Gender : Not SpecifiedMaleFemaleNon-Conforming / Non-Binary

Race : Not SpecifiedAmerican Indian or Alaska NativeAsianBlack or African AmericanOtherNative Hawaiian or Other Pacific IslanderWhite

Hispanic or Latino Not Hispanic or Latino

Address:

City:

State: Zip Code:

Phone Number(with area code: XXX-XXX-XXXX):

Email Address (we will send a confirmation message to this address upon submission of your complaint):

Information about the incident

The FPC investigators understand that the exact address or time of the incident may not be known. Please be as specific as possible.&

Location of the incident:

Date of the incident: Time of the incident : AM PM

Information about the employee

If the employee is not a member of the Milwaukee Police or Fire Departments the FPC will not be able to investigate the incident.

Department: Please SelectMilwaukee Police DepartmentMilwaukee Fire Department

The FPC investigators understand that the full name of the employee may not be known. Please be as specific as possible. For example, report the person's gender, race, approximate age, identifying features (e.g. mustache, long hair, wears glasses, etc.), approximate height, weight, etc.

Name and/or physical description of the employee:

Witnesses / others involved

If there are more people to list than space allowed you may email additional names directly to [email protected]

Person 1:

Last Name :

First Name : Middle Initial :

Birthdate :

Address :

City :

State : Zip Code :

Main Phone Number :

Email Address :

Involvement :

Person 2:

Last Name :

First Name : Middle Initial :

Birthdate :

Address :

City :

State : Zip Code :

Main Phone Number :

Email Address :

Involvement :