TULSA COMMUNITY COLLEGE POLICE DEPARTMENT
COMPLIMENT
COMPLAINT
You may remain anonymous. If you wish to be contacted provide an email address or phone number
(Ud. puede permanecer anónimo. Si deseaser contactado anote su correo electrónico o número de teléfono.
Your Information (Su información) Complaint # (Queja- Número)
You may remain anonymous by not completing the personal fields. __________
Name (Su nombre) Date of Birth (Fecha de Nacimiento):
_________________ ____________________________
Address (Su domicilio): E-mail Address (Correo electronico):
___________________ ______________________________
Home or Cell Phone (Teléfono de la casa o del celular): Other Phone (Otro teléfono):
______________________________________________ ______________________________
Description of the Incident (Descripción del incidente)
Incident Date Incident Time
(Fecha del Incidente):* (Hora del Incidente):
______________________________________ ________________________________
Incident Address or Location (Dirección del incidente o ubicación): *
Summary of Event ((Resumen del Evento): *
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Officer(s) / Employee(s) (Empleados / empleados) *
Name, if known, of Tulsa Community College Police employee(s) you wish to report.
(Nombre, si se conocen, del empleado do la policia de Tulsa que desea informar.)
Officer / Employee Name Badge#
(Oficial / nombre del empleado)
__________________________ __________
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