Fillable Citizen Comment Form

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Citizen Comment Form

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Country of origin: US
File type: PDF

U.S.A. forms for Lexington-Fayette Urban County Government

BROWSE LEXINGTON-FAYETTE URBAN COUNTY GOVERNMENT (KY) FORMS

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Page 1 of 2
LEXINGTON POLICE DEPARTMENT
CITIZEN COMMENT FORM
*If you wish to be contacted for follow up and/or notified of the findings regarding the information you provided, please
provide your contact information below. If you simply want to make us aware of specific conduct and behavior while
remaining anonymous and without further notification, you can leave the personal information section blank.
Today’s Date/Time: ___________________________________________
Reporting Party Information (optional*):
Name*: _____________________________________________________
Address*: ___________________________________________________
Phone*: ________________________________________ E-mail*: __________________________________________
Involved Employee(s) Information (if known):
UName(s): __ _________ Employee (badge)#: Vehicle#:___________
U________________________________________________________________________________________________
_________________________________________________________________________________________________
________________________________________________________________________________________________
Date and approximate time of incident: _______________________________________________
Case Number (if known): __________________________________________________________
Location of incident: _______________________________________________________________________________
Summary of Incident:
(Continue on page 2 if necessary)
If you would like to discuss your matter with someone, contact the Pubic Integrity Unit (PIU): Mon-Fri: 8am – 4pm, in
person, by phone, or email to schedule an appointment:
150 E. Main St
Lexington, KY 40507
859-258-3625
0TUcomment@lexingtonpolice.ky.govU0T
Page 2 of 2
(Continued summary from page 1)
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Citizen Comment Form

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Completed 13 July 2020

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