By filing a complaint regarding officer misconduct, I attest to the following:
I hereby swear or affirm that all of the information that I have provided is true and correct. I fully understand that I will be required to appear, and testify if necessary, at any hearing to which I am requested, related to this complaint. I agree to return to testify when notified, and I realize that failing to do so may result in this complaint being terminated.
I agree to furnish, at my own expense, any medical records or documents and witness names which the LSU Police Internal Affairs investigation may request of me in regard to this complaint. I understand in order for there to be a thorough investigation, that my cooperation is required. And further, that if I fail to cooperate or provide the records or witness names within ten working days of the date of the incident, that the investigation may be terminated.
I fully understand that any false statement I make to LSU Police Investigators or designee, in regard to this complaint, may be a violation of LRS 14:133.5, Filing a False Complaint Against a Law Enforcement Officer. The crime of filing a false complaint against a law enforcement officer is punishable by a fine of up to five hundred dollars ($500.00) or imprisonment in the Parish Jail for up to six (6) months or both.
In the event that I believe I have been retaliated against for filing this complaint, I understand that I may report such information to LSU Police for additional investigation.
I authorize that all information provided on this form, including any and all personal, financial, and academic data may be shared with the LSU Police Department, necessary LSU personnel, and/or law enforcement entities to facilitate thorough investigation and response. This data will be securely retained if required by law or policy, for the scheduled amount of time designated by the LSUPD Records Retention Schedule approved by the Louisiana Secretary of State, Division of Archives.
To learn more about privacy at LSU, please see the LSU Privacy Statement.