Citizen Complaint Form of Firefighter Action - Fort Wayne Fire 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling in the 'Date of Report' section. Enter the month, day, and year accurately.
3. In the 'I.A. Case No.' field, provide any relevant case number if applicable.
4. Complete your personal information by entering your name, age, sex, race, address, city, state, zip code, home phone number, work phone number, birth date, social security number (required), and place of employment.
5. Detail the incident location and date. Specify the time and list any officers involved.
6. Indicate whether an arrest was made or a ticket issued. If yes, specify the charges.
7. If you sustained injuries requiring medical treatment, provide details including hospital name and date of treatment.
8. List witnesses by providing their names, ages, birth dates, addresses, and phone numbers.
9. In the narrative section, describe the incident thoroughly. Ensure all facts are clear and concise.
10. Finally, sign the form to affirm that all information is true to your knowledge before submitting it promptly after the incident.

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