Complaint Form First Name Middle Name Last Name Preferred Name Home Phone # Mobile Phone # Work Phone # Email Address Date of Birth November January February March April May June July August September October November December 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Sun Mon Tue Wed Thu Fri Sat 27 28 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 Street Address City -- State -- Louisiana Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code -- Parish -- --Parish-- Not in Louisiana Acadia Allen Ascension Assumption Avoyelles Beauregard Bienville Bossier Caddo Calcasieu Caldwell Cameron Catahoula Claiborne Concordia DeSoto East Baton Rouge East Carroll East Feliciana Evangeline Franklin Grant Iberia Iberville Jackson Jefferson Jefferson Davis Lafayette Lafourche Lasalle Lincoln Livingston Madison Morehouse Natchitoches Orleans Ouachita Plaquemines Pointe Coupee Rapides Red River Richland Sabine Saint Bernard Saint Charles Saint Helena Saint James Saint John the Baptist Saint Landry Saint Martin Saint Mary Saint Tammany Tangipahoa Tensas Terrebonne Union Vermilion Vernon Washington Webster West Baton Rouge West Carroll West Feliciana Winn -- Preferred Contact -- Home Phone # Mobile Phone # Work Phone # Email Postal Mail No Contact Requested -- Language -- English Spanish French Vietnamese Arabic -- Ethnicity -- White / Caucasian Black / African Hispanic Asian Other -- Gender -- Male Female Other Prefer not to answer Were you injured Date of Incident November January February March April May June July August September October November December 2024 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Sun Mon Tue Wed Thu Fri Sat 27 28 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 : PM Ok Location of Incident Crash Report # Citation # Describe Incident Officer Number 1 Officer's Name Badge # -- Department -- DPS LSP Unknown -- Vehicle Type -- Car SUV Motorcycle Unmarked Car Vehicle # Describe the Officer Describe the Officer's Vehicle Witness Number 1 First Name Last Name Email Address Phone # Your relationship to the witness and their involvement Select your attachments save Submit