Where did the incident(s) that led to your complaint happen? If you do not know the address or street names please include landmarks etc.
Incident #1
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Hour
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Minute
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Add Incident
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From*
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January February March April May June July August September October November December
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To*
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Month
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January February March April May June July August September October November December
Year
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What is your complaint about?
Describe in detail what specifically caused you to make a complaint. Consider the following:
What did the officer(s) do, say or did not do that has caused you to make this complaint?
Based on your complaint, what do you think the officer(s) should have done or said?
Describe any injury or damage as a result of what the officer(s) did or didn't do.
If you are not the directly affected person, outline how you were affected (e.g. loss, damage, distress, and/or inconvenience).
Identify any evidence of the incident(s) you have (e.g. photo, audio, video, medical records).
If this happened to someone else and you are a witness to the incident, please include the name and contact information of the person this happened to (if known).
Complaints may be screened out if they are made more than six months after the incident. If the incident you are complaining about happened more than six months ago, please indicate if you are under the age of 16, if
you are a person with a disability, if there is a criminal case in relation to this incident and/or if there is any other reason for your delay in making the complaint.
Summary of complaint*
Additional Information
Please indicate if you need to be accommodated in the event of an interview.
I used a translator to fill out this form, and I will need to arrange for a translator in the event of an interview
I will require an ASL or LSQ interpreter
I will require a telephone typewriter service for interviews over the phone and my translator to be present for in-person interviews
Translator's Declaration
I declare that I have accurately translated the entire content of this form for the complainant from English to the following language:*
Declaration
I certify that the information provided is true. I understand the information on this form will be provided to the police chief
or the OPP Commissioner in care of their professional standards unit or the police services board, and that this complaint may be investigated
by the professionals standards unit of the service I am complaining about, with oversight by the OIPRD.
Name*
Signed (acknowledge by checking box)*
I am represented by an agent
Name of agent*
Please enter contact details of agent*
Freedom of Information and Protection of Privacy
The personal information that you have provided on this complaint form is collected by EJC under the Police Services Act.
The information will be used to investigate your complaint. As an agency of the government, EJC must adhere to the Freedom of Information and Protection
of Privacy Act (FIPPA). If you have any questions about privacy protection, please contact the Freedom of Information and Privacy Office
at the Ministry of the Attorney General at 416-326-4300
Personal Information Collection
EJC is collecting complainants' personal information under the Police Services Act (PSA) for program development and to improve
service delivery. We are collecting this information in support of the OIPRD’s powers under the PSA, including sections 57 and 92.
The information will be used to help ensure fair and equitable treatment in our services, programs and policies.
Answering these questions is completely voluntary. Whether you choose to answer these questions or not will not affect any service
provided or decision made by EJC. This personal information will be kept confidential. It will also not be shared with police chiefs,
the OPP Commissioner, their professional standards units, police services or police services boards. For more information about this initiative,
please email info@equaljusticecanada.ca
In our society, people are often described by their race or racial background. For example,
some people are considered "White" or "Black" or "East Asian," etc.
Which race category best describes you? Select all that apply.
Examples/descriptions
Black
African, Afro-Caribbean, African-Canadian descent
East Asian
Chinese, Korean, Japanese, Taiwanese descent
Indigenous
First Nations, Métis and/or Inuk/Inuit descent
Latino
Latin American, Hispanic descent
Middle Eastern
Arab, Persian, West Asian descent, e.g., Afghan, Egyptian, Iranian, Lebanese, Turkish, Kurdish, etc.
South Asian
South Asian descent, e.g., East Indian, Pakistani, Bangladeshi, Sri Lankan, Indo-Caribbean, etc.
Southeast Asian
Filipino, Vietnamese, Cambodian, Thai, Indonesian and other Southeast Asian descent
White
European descent
Another race category not described above
Submit