Forms • City of Rowlett • CivicEngage

I Would Like to File a Complaint on an Employee

Leave This Blank:

What is Your First Name?*
What is Your Last Name?*
What is your home address? (House Number, Street, City, State Zip)
What is the best way to contact you? By phone or email? Please provide your contact information. *
If you know the employees name please type here:
If don't know the employees name, please describe each employee involved.
How did you come into contact with the employee?*
What was the date of this incident?*
What time did this happen?*
What was the address or location of the incident? Please be specific.*
Please give a detailed description of what happened.*
Was there anyone with you during the incident?*
If someone was with you please provide their name, address, and phone number(s)
I understand that I may be asked to give a sworn written affidavit to proceed with this complaint.

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