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Welcome

This form is to be used if you have a complaint involving a Special Constable with the Peterborough Police Service.

Today's Date

Have you previously filed a complaint with the Peterborough Police Service?

Yes

Is this complaint related to an ongoing criminal court proceeding?

Yes

How would you like correspondence to be sent to you?

Mail

Complainant's Information

First Name

Last Name

Date of Birth

Street Address

City

Postal Code

Phone Number

Email Address

If you are under the age of 16, please provide your Guardian's name and contact information:

First Name

Last Name

Date of Birth

Street Address

City

Postal Code

Phone Number

Email Address

Special Constable Details

Name

Badge #

Name

Badge #

Incident Details

When did the incident(s) occur? If there is more than one incident, include each date.

Date of Incident

Time of Incident

Date of Incident

Time of Incident

Complaints may be screened out if they are made more than six months after the incident. If the incident occurred more than six months ago, please provide the reason(s) for the delay in filing your complaint.

Where did the incident(s) occur that led to your complaint? If you do not know the address or street names, please include landmarks, etc.

Address/Location

Nearest Intersection

City

Describe in detail what specifically caused you to make a complaint. Consider the following:

What did the Special Constable(s) do, say or did not do that has caused you to make this complaint?
Based on your complaint, what do you think the Special Constable(s) should have done or said?
Describe any injury or damage as a result of what the Special Constable(s) did or didn't do
If you are not the directly affected person, outline how you became aware of the incident (e.g. witness, saw in media/social media) and how you were affected (e.g. loss, damage, distress, and/or inconvenience)
Identify any evidence of the incident(s) you (e.g., photo, audio, video, medical records. Evidence does not need to be included at this time. All relevant information and evidence will be obtained at the time of investigation if the matter proceeds.
If this happened to someone else and you are a Witness to the incident, please include the name and contact information of the person that this happened to (if known).

Describe the incident

Supporting documents

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Accomodation

If you have disability, accommodations are available under the Ontario Human Rights Code and the Accessibility for Ontarians with Disabilities Act (AODA).

Accommodation Required?

Yes

Declaration

I certify that the information provided in this form is true. I understand the information on this form will be provided to the Peterborough Police Service Chief of Police and that this complaint may be investigated by the Professional Standards Unit of the Peterborough Police Service. I further understand that providing false information could make me subject to prosecution under the Criminal Code.

Name

Date

Municipal Freedom of Information and Protection of Privacy

The personal information that you have provided on this complaint form is collected by the Peterborough Police Service under the Community Safety and Policing Act. The information will be used to investigate your complaint. As an agency of the government, the Peterborough Police Service must adhere to the Freedom of Information and Protection of Privacy Act (FIPPA).