Submit Online Complaint On the on-line complaint form, the * indicates this information is required in order to process your complaint. Please be as precise as possible. Your Contact DetailsTitleTitle:Mr.Mrs.Ms.Miss.Dr.First Name*Last Name* Please provide at least one form of contact. Street AddressCityProvincePostal CodeMain PhoneAlternate TelephoneEmail Date of Birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920DemographicsThe Office of the Police Complaint Commissioner is responsible for compiling information related to the characteristics of persons who make complaints (i.e. statistical demographics), such as age, gender and ethnicity pursuant to section 177(2)(e)(i) of the BC Police Act (2010). The purpose of collecting this information is to identify any trends relating to persons who make complaints. Answering this question is completely voluntary and will not affect any service provided or decision made by the OPCC. This personal information will be kept confidential and will not be shared with police departments or police boards unless you file a complaint directly with the police department. The OPCC is mandated to report publically on the aggregate data collected which will group the information you provide with other complainants. It will not contain any identifying information. For more information about the collection of demographics, please contact email@example.com GenderPlease specify the gender you identify withEthnicity: (please select all that apply) Black - African, Afro-Caribbean descent/African Canadian East Asian – Chinese, Korean, Japanese, Filipino, Vietnamese and other Southeast Asian descent Indigenous – First Nations, Inuit or Métis descent Latino – Latin American or Hispanic descent Middle Eastern – Arab, Persian or West Asian descent e.g., Afghani, Turkish, Kurdish South Asian – Indian Subcontinent descent e.g., East Indian, Pakistani, Bangladeshi, Sri Lankan, Indo-Caribbean etc. White – European descent Another ethnic category Another ethnic category – please specify:Details of the ComplaintWhen did the incident happen?*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Time it occurred?* : Hour Minutes AM PM Where did the incident Happen*Name of the Police Department Involved:*Name of the Police Department Involved:AbbotsfordCentral SaanichCFSEUDeltaNelsonNew WestminsterOak BayPort MoodySaanichSCBC Transit PoliceStl'atl'imx Tribal PoliceVictoriaVancouverWest VancouverRCMP*Unknown*Complaints regarding RCMP members should be sent to the Civilian Review and Complaints Commissioner (CRCC) for the RCMP. They are an independent agency that reviews complaints made by the public about the on-duty conduct of RCMP members. To make a complaint with the CRCC you can visit their site at www.crcc-ccetp.gc.caPolice File Number (if known):Name or badge number of Officer(s) (if known):Were there any witnesses? If so, please list their names and contact information:Describe your injuries (If any):If you received treatment for your injuries, where were you treated and when? What is your complaint about? Describe in detail what specifically caused you to make a complaint. Consider the following: What did the officer(s) do, say or did not do that has caused you to make this complaint? Based on your complaint, what do you think the officer(s) should have done or said? Describe any injury or damage as a result of what the officer(s) did or didn't do. Identify any evidence of the incident(s) you have (e.g. photo, audio, video, medical records). If this happened to someone else and you are a witness to the incident, please include the name and contact information of the person this happened to (if known). A complaint must be made within the 12-month period beginning on the date of the conduct giving rise to the complaint. The Police Complaint Commissioner may extend the time limit for making a complaint if the Police Complaint Commissioner considers that there are good reasons for doing so and it is not contrary to the public interest. Please describe the incident: Complaint Resolution The main goal of Complaint Resolution is to provide complainants and police officers an opportunity to engage in a process where they can share their perspectives and find common ground with the aim of coming to a resolution agreement between both parties. I would consider participating in a Complaint Resolution process or Mediation for this matter if my complaint is determined to be admissible and appropriate for this process. Declaration: I certify that the information provided is true. I understand the information on this form will be provided to the Chief Constable, in care of their Professional Standards Unit or the department’s Police Board, and that this complaint may be investigated by the Professional Standards Unit of the department I am complaining about with oversight provided by the Office of the Police Complaint Commissioner. I understand that a Professional Standard Investigator or an OPCC Investigative Analyst may reach out to me to obtain further information about my complaint and may request my participation. Signature Name*Signature Acknowledgement* Signed (Acknowledge by checking box) Freedom of Information and Protection of Privacy - The personal information that you have provided on this complaint form is collected by the OPCC under the Police Act. The information will be used to investigate your complaint. The OPCC is required to adhere to the Freedom of Information and Protection of Privacy Act (FOIPPA). If you have any questions about privacy protection, please contact the Office of the Information and Privacy Commissioner for B.C. at (250) 387-5629, firstname.lastname@example.org or visit their website at, https://www.oipc.bc.ca CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.