ITDept@bristolct.gov
111 North Main Street, Bristol, CT, 06010, US
860-584-6100
This form is not for routine complaints.
If you have a complaint, please call dispatch at (860) 584-3011.
Date & Time of Incident
Date & Time Reported
Location of Incident
Complainant's Name
Complainant's Address
Complainant's Date of Birth
Witness's Name
Witness's Address
To your knowledge, was the incident recorded via audio or video?
Are you afraid for your safety, or that of any other person, for any reason as a result of making this complaint?
Has anyone threatened or tried to intimidate you in an effort to prevent you from making this complaint?
Are you able to read, write, and speak the English language?
If you are unable to read, write, or speak English, have you been provided with adequate language assistance to help you understand and fill out this form?
Please attach supporting documentation if appropriate (Letters, Emails, Photographs, Videos and/ or Audio Recordings etc.)
By providing my signature I attest that I have read, or had read to me, the above information and that all of the information provided is true and accurate to the best of my knowledge. I understand that making a false statement intended to mislead a law enforcement officer in his or her official function is a violation of Connecticut General Statute 53a-157b, and could result in my arrest and being fined and/ or imprisoned.
Sign Here
Date and Time Signed
By clicking this checkbox I am acknowledging that this form is strictly intended to be used for the purpose of filing an official complaint against a police officer of the Bristol, Connecticut Police Department, and not to be used for routine complaints.
