Citizen Complaint Form

Citizen Complaint Report

City of Pharr PD
1900 S. Cage Blvd.
Pharr, Texas 78577
956-402-4700
Division:
Complainant Information
Name - Complainant*

First NameLast Name
Address - Complainant*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone # - Complainant*
Please enter a valid phone number.
Email - Complainant
example@example.com
Occupation
Age
Race
Sex
Business Name
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

First Witness
Name - 1st Witness

First NameLast Name
Phone # - 1st Witness
Please enter a valid phone number.
Address - 1st Witness

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Second Witness
Name - 2nd Witness

First NameLast Name
Phone # - 2nd Witness
Please enter a valid phone number.
Address - 2nd Witness

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Officer Information
Name - Officer

First NameLast Name
Badge #
Unit/Assignment

Incident Details
Date

MonthDayYear
Date
Day of week
Month
Year
Time of day
Location
Details of complaint:

State Of Texas Penal Code:

Sec. 37.08: False Report to a Peace Officer. (A)

A person commits an offense if he/she:
1. Reports to a peace officer an offense or incident within the officer’s concern, knowing that the offense or incident did not occur; or
2. Makes a report to a peace officer relating to an offense or incident within the officer’s concern knowing that he has no information relating to the offense or incident.
  - An offense under this section is a class b misdemeanor
Initials* I have read the attached complaint report and concur that it is a true and complete statement relative to the actions of the member(s) of the Pharr police division.

Initials* I further state that i have read Texas penal code section 37.08 and fully understand that i can be prosecuted for violation of said selection.
Should be Empty: