The members of the Rapid City Police Department are committed to law enforcement services that are fair, effective and impartially applied. In order for us to effectively manage our department, we need to hear from those we serve. This form is provided for you to provide us with details about your contact with members of the Rapid City Police Department that did not meet your expectations. It is in the best interest of everyone that your complaint about the performance of an individual officer is resolved fairly and promptly.

Personal Information Please provide your name, address and contact numbers or you can remain anonymous:
First Name
Last Name
Address	Street Address
	City State Zip
Email
Home Phone
Work/Cell Phone
Officer Information Please provide the following information to assist in the identification of the involved officer(s):
Officer's Name Badge ID# Vehicle # Other Desc. Officer's Name Badge ID# Vehicle # Other Desc. Additional Officers:
Incident Information Please provide details of the incident:
Date/Time Location
Description of Incident What do you believe would be a satisfactory resolution to this complaint: Would you like to contacted about this incident? Yes No
Type the characters you see in the picture below. Letters are not case-sensitive.
By submitting this form, I verify that the statements made are true.