This page is provided for your reference. Below you will find a provision to download a copy of an actual Record of Complaint, should one be required. The professional Standards Officer or the Office of the Police Complaint Commissioner, can assist you in completing the form. For reasons of security and authenticity, it is preferred that a hard copy form is received. If you choose to forward an electronic copy, you will be required to forward the original, either by mail or in person. Please remember to include a phone number where you can be reached during business hours.

The Professional Standards Office is available Monday through Friday 8 a.m. to 5 p.m. at (250) 475-4363 or by pager at (250) 389-6624.

The mailing address is:


The Saanich Police Department
760 Vernon Ave
Victoria B.C.
V8X-2W6
Attention: Professional Standards Office

(NOTE: The remainder of this page is best viewed on a full screen. The document will lose format if viewed on some smaller screens)

 

Form 1
RECORD OF COMPLAINT
[Section 52(4) Police Act]
[Download Copy in Word]

COMPLAINANT’S NAME: ……….………………….[surname] ………………………[Full given names]

COMPLAINANT’S ADDRESS:

Home: 
 
[Address] [Postal Code] [Telephone]
 Office
 
[Address] [Postal Code] [Telephone]
DETAILS OF THE COMPLAINT :

When did the incident occur? ………………………. [day/month/year]...………… [Hour]A.M./P.M. 

Where did it occur? 

DESCRIPTION OF THE INCIDENT – (In as much detail as possible) (Use reverse if necessary)

WITNESSES: (If any)

Name 

Address 

Telephone no.
 

NAME OF OFFICER(S) INVOLVED: (If known)

COMPLAINANT’S SIGNATURE: ..………………………… Date: …………………… [day/month/year]



For office use only:
RECEIVED BY: Date:………………… [day/month/year]
FILE NUMBER ASSIGNED: Date:………………… [day/month/year]
P.I.N. OF OFFICER(S) INVOLVED (if known): …………………………………………………..……..
FORWARDED TO:
Police Complaint Commissioner: Date: …………………. [day/month/year]
Chief Constable Date: …………………. [day/month/year]
ENTERED INTO COMPUTER: Date:………………….[day/month/year]
 

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