ࡱ> 685W bjbjzBzB 7$(a(a  22222FFF8~$F|$!h!222@F22wxLV0 "#( " "2<K^ " B : CASE NUMBER __________________ C.S.U. Bakersfield Police Department Personnel Complaint Form Reported By _______________________________________________________________________________________________________________ Residence Address ___________________________________________________________________ Phone # _____________________________ Business Address ____________________________________________________________________ Phone # _____________________________ Date & Time of Occurrence: _____________________________________ Location of Occurrence: _______________________________________ Employee(s) Involved: _______________________________________________________________________________________________________ Type of Complaint: _________________________________________________________________________________________________________ Complaint is racial or identity profiling: __________________________________________________________________________________________ Explain the type of racial or identity profiling: _____________________________________________________________________________________ Additional Complaints of racial or identity profiling: _________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ Witness #1: ________________________________ Address _______________________________________ Phone # _____________________ Witness #2: ________________________________ Address _______________________________________ Phone # _____________________ Brief Description of Circumstances: ____________________________________________________________________________________________ _________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________ (Attach Additional Pages If Necessary) _________________________________________________________________ Signature of Complainant ______________________________________________________________ Date ________________________ _________________________________________________________________ Complaint Received By ________________________________________________________________ Date ________________________ ________________________________________________________________________________ OFFICE USE ONLY Investigation Assigned To: _____________________________________________ Findings of Investigation: % Unfounded % Exonerated % Not Sustained % Sustained % HR Notified % Complainant Notified Original  Investigator / File Copy  Complainant FORM Updated march 2016      \]^X X I"$>@\^  嬸ĐĐ~~~~~~ohp>6CJOJQJ]^Jhp>CJOJQJ^J hp>CJhp>5CJ\hp>hp>5CJOJQJ\^Jhh CJOJQJ^Jhi CJOJQJ^J hp>CJhp>CJOJQJ^Jhp>5CJOJQJ\^Jhp>CJOJQJ^Jhp>5CJOJQJ\^J%D]^_X Y Z [ W X h i 0]0^ $0]0^a$ |]|^ $|]|^a$$a$$0]0a$ m n efcd/ $0]0^a$ $0]0a$gdh 0]0^ $0]0^a$ 0d]0^ 0]0^I  t $0]0^a$ $0]0^a$ 0]0^ 0]0^ $0]0^a$$08]0^`8a$ &:HNrth/Ajh/AU hi 6]hi 6CJOJQJ]^Jhp>6CJOJQJ]^Jh4u~6CJOJQJ]^J $0]0^a$5P<0/ =!8"#$% Dps2&6FVfv2(&6FVfv&6FVfv&6FVfv&6FVfv&6FVfv&6FVfv8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH 8`8 Normal_HmH sH tH HH  Heading 1 $$a$CJOJQJkHLL  Heading 2 $$a$5CJOJQJkHFF  Heading 3$@&5OJQJ\^J@@  Heading 4$$@&a$5\JJ  Heading 5$$@&a$5CJ OJQJZZ  Heading 6$$@&^`a$5CJOJQJJJ  Heading 7$$@&a$CJOJQJ^J`@`  Heading 8$$0@&]^0a$5CJOJQJ\^J` @`  Heading 9 $$0@&]^0a$5CJOJQJ\^JDA D Default Paragraph FontViV  Table Normal :V 44 la (k (No List :": Caption5OJQJkH@B@ Body Text6CJOJQJ]DPD Body Text 25CJOJQJ\4"4 Header  !4 24 Footer  !6UA6 Hyperlink >*B*phRYRR  Document Map-D M OJQJ^J6b6  Footnote Text@&q@ Footnote ReferenceH*FQ@F Body Text 3 ] OJQJ^JVT@V Block Text$0]^0a$CJOJQJ^JPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭Vc:E3v@P~Ds |w< $$     8@0(  B S  ?hj \a33333   h i r~4u~p>q/Aj 6@ @ UnknownG*Ax Times New Roman5Symbol?. *Cx ArialArialABook Antiqua5.*!TahomaA$BCambria Math"h3C3Cxf6 6 43HP ?h 2!xx]  Babara BrennerKenneth WilliamsOh+'0   @ L X dpx Babara BrennerNormalKenneth Williams2Microsoft Office Word@@xZ/@v8x@v8x6 ՜.+,0 hp  ֱ  Title  !"#$&'()*+,./012347Root Entry F@x91Table "WordDocument7$SummaryInformation(%DocumentSummaryInformation8-CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q