2. Aventura Police Case or Citation Number
3. Date of Incident
   Date of Incident
4. Time of Incident
   Time of Incident
6. Location of Incident
8. Address
10. City
11. State
12. Zip Code
14. Conduct Allegation
15. Name of Person Making Complaint
17. Contact Information
19. Address
21. City
22. State
23. Zip Code
25. Phone Number
26. Alternate Phone Number
28. Witness to Incident
    Witness to Incident: If there is more than one witness, please include their names and contact info into the explanation field.
30. Address
32. City
33. State
34. Zip Code
36. Phone Number
37. Alternate Phone Number
39. Employees Involved
41. Employee 1
43. Name
44. Position
45. ID Number
47. Employee 2
49. Name
50. Position
51. ID Number
53. Specifics of Complaint
55. You will be contacted by mail regarding this submission within 48 business hours. Call Internal Affairs to verify receipt of your submission at 305-466-8989, ext. 8147.
57. Staff Use Only
59. Received by
60. Date Received
    Date Received
61. Assigned to for Investigation
63. Date Due Back
64. Assigned by
65. Date Assigned
67. The assigned investigator/supervisor is required to send a weekly update of the status of the investigations to I.A. Extensions beyond the due date must be approved by the appropriate Division Commander.
Leave This Blank:


69. 1. Receive an email copy of this form.
70. Email address

    This field is not part of the form submission.

71. Submit

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