Lodge a complaint | Western Cape Police Ombudsman

Capture Complaint

Name

Surname

Nationality

Identity or Passport Number

Home Tel No

Work Tel No

Cell No

Fax

E-mail

Complaining on behalf of complainant

Name

Surname

Nationality

Identity or Passport Number

Home Tel No

Work Tel No

Cell No

E-mail

Fax

Is mandate submitted

Unit No/Complex Street Suburb City / Town Postal Code

Is same as residential address

P.O. Box Street Suburb City / Town Postal Code

Name of Officer

Persal/Force Number of Officer

Date Occured

Agency Type

Police Station

Case Reference Number

Place of occurrence

Preferred method of correspondence

Provide a short explanation of the complaint

Provide a description of incident and explain why you believe that the complaint should be investigated

Provide names and address of any other person who could provide the information relevant to the complaint

Provide information regarding other mechanisms you used to try to resolve the complaint

Please share your expectations from this office

Please upload your ID. Note:If the ID is not uploaded, the complaint will not be accepted

I, the complainant whose details are provided above, confirm that the information provided by me is to the best of my knowledge true and correct