Compliment/Complaint Form - Westhampton Beach, NY

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Instructions:

INSTRUCTIONS: If you would like to compliment a Westhampton Beach Police Department employee, or file a complaint against a police employee, please write legibly and fill out this form. Personal information will not be disclosed to the public, unless required bylaw. You can submit this form by mailing or returning it to the Westhampton Beach Police Department at the address given at the top of this page.
I wish to file a (please check one):
- Compliment
- Complaint
You may file a compliment or complaint anonymously. Please understand filing anonymously does not provide the opportunity to contact your for more information or advise you of the actions related to your compliment or complaint.
Do you wish to remain anonymous?
- Yes
- No
Reply Email
Are you filing this on behalf of someone else?
- Yes
- No
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Police Officer or Employee involved
Name or ID # of Officer or Employee
Narrative Section
Date
Month
Day
Year
Time

: Hours

Minutes
Location or Address of Incident:
Street Address Address Line 2
Witness Name:
First Last
Witness Address, City State & Zip
Street Address Address Line 2 City State ZIP Code
I attest that the above information and my statement are true and correct to the best of my recollection.

Enter First and Last Name Digital Signature Submittal
Name
This field is for validation purposes and should be left unchanged.

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