NOT PROTECTIVELY MARKED Making A Complaint Against The Police

not protectively marked making a complaint against the police completing the form please use block capitals when completing

NOT PROTECTIVELY MARKED
Making a complaint
against the Police

Completing the form
Please use BLOCK CAPITALS when completing this form. If you have any
difficulties in filling out this form, and would like to discuss it
please call 101. If you would like someone to act on your behalf
(perhaps a friend or relative) please provide their details and your
written permission for them to act on your behalf and submit this with
your form.

Your details (complainant)
Title: e.g. Mr, Miss, Mrs, Ms ………………………... First name:
…………......................
Surname: …………………………............................. Date of birth:
…………....................
Address: ………………………………………………………………………………………….……
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…………………………………………………………….. Postcode: …………..……………......
Work telephone ……………………………….. Home telephone number……………..………
Mobile telephone number: …………………… Email: ………………………..…………………
Who are you complaining about?
Please give the details of who you are complaining about – for example
the police force / Police and Crime Commissioner or the Mayor’s Office
for Policing and Crime.
………………………………………………………………………………………..
For complaints against the police please give us any details you might
have about the officer(s) you would like to make a complaint against:
Name, rank, ID and any other identifier: ………………………………………………
Name, rank, ID and any other identifier: ………………………………………………
If you know the police station that the officer/s work from, please
give details:
………………………………………………………………………………………..
What is your complaint about?
Please describe the circumstances that have led to your complaint?
Include details of:
*
Who was involved?
*
What was said and done
*
Where the incident took place
*
When the incident took place
*
If there was any damage or injury
*
Any other people who witnessed the incident
*
Details of any witness
At this stage we only require a summary of your complaint, but you may
attach additional information if necessary. Please use the space
provided on the last page of this form.
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Signature and date
The details of this complaint will be sent to the appropriate
authority responsible for considering your complaint. Please sign and
date to confirm the information you have provided is correct:
Signature……………………………. Date………………………………
South Yorkshire Police Diversity Monitoring Form
SYP DECLARATION
The information required is crucial in enabling South Yorkshire Police
(SYP) to monitor, by protected characteristics, its workforce and
service users. In order to meet its legal obligations under the
Equality Act 2010 to eliminate unlawful discrimination and promote
equality of opportunity, SYP will monitor in accordance with Home
Office requirements.
The information required of you is the minimum necessary to enable
South Yorkshire Police (SYP) to fulfil the above requirements.
The information will:
*
be used for monitoring purposes only
*
be securely retained by SYP Professional Standards Department
*
be processed in accordance with the Data Protection Act 1998
*
only be processed by a small number of authorised people.
SYP is required to publish the results of its monitoring under the
legal requirements above whilst also
ensuring confidentiality is maintained and the individual to whom
Personal Data and Sensitive Personal Data pertains, is not identified.
PERSONAL DETAILS
GENDER
FEMALE
MALE
GENDER IDENTITY
Please indicate if you consider yourself to be Transgender.
(For monitoring purposes the term Transgender is used to include:
Hermaphrodite/Intersex, Transgenderist, Transsexual, Transvestite)
Y
N
MARITAL STATUS
In Civil Partnership
Co-habiting
Divorced
Married
Separated
Single
Widowed
DATE OF BIRTH
WORKING PATTERN
FULL - TIME
Part - Time
Job - Share
DISABILITY / IMPAIRMENT
Please indicate below* if you consider yourself to have a disability
within the meaning of the Equality Act 2010.
NOTE: The Act defines disability as a ‘physical or mental impairment,
which has a substantial and long-term adverse effect on that person's
ability to carry out normal day-to-day activities’.
Should you elect the option ‘Prefer not to say’, this will not be
interpreted as being indicative of a disability
This information is for monitoring purposes only.
*Yes
*No
Prefer not to say
ETHNICITY
(Please identify the code which corresponds to your ethnicity)
Major Categories Description & Code
Sub-Groups Description
Code
Please tick
Asian or Asian/British
Indian
A1
Pakistani
A2
Bangladeshi
A3
Any other Asian Background (please specify)
A9
Black or British
Caribbean
B1
African
B2
Any other Black background (please specify)
B9
Chinese
Chinese
O1
Mixed
White and Black Caribbean
M1
White and Black African
M2
White and Asian
M3
Any other Mixed background
M9
White
British
W1
Irish
W2
Any other white background (please specify)
W9
Other
Any other Ethnic Group (please specify)
O9
Not Stated
NS
RELIGION
AND BELIEF
Buddhism
Islam
No Religion
Christianity
Judaism
Other -
Hinduism
Sikhism
Prefer Not to say
SEXUAL ORIENTATION
Prefer not to say
Lesbian
Gay
Bisexual
Heterosexual
SIGNATURE (to confirm content has been fully understood).
Date
D
D
M
M
Y
Y
Y
Y
Where to send this form
Professional Standards Department
South Yorkshire Police
Unit 20 35A Business Park
Churchill Way
SHEFFIELD S35 2PY
Or via email to: [email protected]

A dditional notes
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NOT PROTECTIVELY MARKED