Complaint

| Complainant Information

Name

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Gender

Race

Date of Birth

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Address

Apt/Unit/Suite

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Home Phone

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Work Phone

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Confirm Email

Select this if would you like to receive communications via e-mail

| Representative Making a complaint on behalf of someone? Please complete this section.

Name

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Relationship to Complainant

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Address

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Home Phone

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Work Phone

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| Incident Information

Can you identify the Officers involved?

Yes

Incident Location

Unknown

Date of Incident

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Hour of Incident

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Brief Narrative Description of Incident

Were you injured?

Yes

Were there any witnesses?

Yes

Was the complaint also filled through other entity?

Yes

What would you like as a result of this complaint?

Decline to state

Is complainant a minor or assisted by an attorney or other representative?

Yes

| Upload supporting materials

Please upload any evidence that you feel may be important such as copies of citations, police reports, photographs, audio or video recordings, etc. Once your complaint has been initiated you will have the opportunity to submit further documentation or evidence either to our office, or electronically through the “follow my complaint” functionality included if you register as a user through this website.

Drop a file here or browse to upload

| Complainant’s Signature

By checking this box, I hereby attest that I have read and understood this statement, which I have made of my own free will, and that all information provided in this complaint is true and correct to the best of my knowledge.

Complainant’s Initials

Date

04-18-2024

| Notice and Releases

The Oakland Community Police Review Agency (CPRA) investigates complaints against members of the Oakland Police Department. The CPRA process (civilian complaint review) is a PUBLIC PROCESS. This means that all the information you provide to the CPRA and any information you authorize the Oakland Police Department to release to the CPRA will be maintained in CPRA files for a period set by the California Public Records Act, and may be released to the public under certain circumstances.

I have read and understood that the information gathered during the investigation is a matter of public record, and may be released to the public under certain circumstances.

Complainant’s Initials

Date

04-18-2024

In order for the CPRA to effectively investigate your complaint, you must authorize the Oakland Police Department to release to the CPRA the following information to which you are entitled by law [Cal. Gov’t Code §6254(f)]: any statements you have given or may give in the future to the Oakland Police Department regarding this incident, the names and addresses of persons involved in or witnesses to the incident (other than confidential informants), the description of any property involved, the date, time, and location of the incident, all diagrams, statements of the parties involved in the incident, and statements of all witnesses (other than confidential informants).

I have read and understood the above and authorize the Oakland Police Department to release the above information to the CPRA.

Complainant’s Initials

Date

04-18-2024