Bonney Lake Police Department COMPLAINT/COMMENDATION FORM

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Complaint-NOT FOR FILING A POLICE REPORT

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I CERTIFY OR DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. (RCW 9A.72.085)

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BONNEY LAKE POLICE DEPARTMENT USE ONLY

Complaint Number: ____________________________

Date Received: _______________________ Person Receiving Report: _____________________
Referred to: __________________________ Disposition: ________________________________
LT/AC Review: ________________________ Chief Review: ______________________________

BONNEY LAKE POLICE DEPARTMENT
Our Core Value is Truth~VERITAS...Vigilance, Excellence, Respect, Integrity, Teamwork, Accountability, Service
18421 Veterans Memorial Dr. E., Bonney Lake, WA 98391 Office 253-863-2218 Fax 253-863-2661
Updated version 05-15-12. All other versions are invalid