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BUREAUS VICE
VICE COMPLAINTS

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Date of Occurrence: (if known)

Time of Occurrence: (approximate)

Name: (optional)

Address: (optional)

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State: (optional)   Zip Code: (optional)

Phone Number: (optional)

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Complaint type: 

Please detail activity taking place (be specific):

Please list the location of the incident:

Please list any information that can assist
in the identification of employee(s) involved:

(Race, sex, height, weight, hair color, specific features, speech,
or any other information available.)

Please record the specific complaint below:
(Be as complete as possible.)