Citizen's Comment Form

Completing this form is the official procedure for reporting either commendable actions, or complaints, regarding a Benton County Sheriff's Office (BCSO) employee or volunteer.

This is a *

Commendation

Complaint

Your Name

Your Address

City

State

Zip

Your E-mail Address

Home/Cell Phone

Work Phone

Gender

Male

Female

No Answer

Age

Date of Birth

Month

Day

Year

Date of Incident

Month

Day

Year

Time of Incident

Hour

Minute

Name of BCSO Member

Initial Contact

(i.e. Traffic Stop, Accident Scene, etc.)

Description of Incident

Witnesses

Please provide the names, addresses, and phone numbers of any persons who may have knowledge of this incident.

Acknowledgement

As a concerned citizen, I hereby attest that all items reported by me are true and factual and that I am willing to avail myself to the Benton County Sheriff's Office staff for further clarification of this matter. (ORS 162.085 Unsworn Falsification)

Citizen's Comment Form

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Citizen's Comment Form

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