Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Citizen Complaint Form

  1. Kinston Department of Fire and Rescue Seal

  2. Kinston Department of Fire and Rescue

    P. O. Drawer 339, 401 E Vernon Avenue Kinston, North Carolina 28502 Office Phone: 252-939-3164 Fax Phone : 252-939-3157

  3. Citizen Complaint Form

  4. Complainant's Information

  5. Race:*

  6. Note: Selecting Yes will not make any difference in the preliminary investigation and the preliminary investigation will proceed in a timely, appropriate, and unbiased manner. If the reported complaint is found to be a criminal act, Anonymity only is for the preliminary investigation into the accusation. By constitutional law under the 6th Amendment the Accused has the right to face the Accuser if the proceedings find the accused accountable for their actions. If the reported complaint is found to be a civil matter, the Anonymity can continue throughout the process.

  7. Nature of the Complaint

  8. Complaint Against:*

  9. If Personnel please fill this section

  10. If Fire Company please fill this section

  11. If Shift please fill this section

  12. Is the Offense Criminal in nature or Civil in nature?*

  13. Explanation:

  14. Definition of Criminal in nature: Violations of the City, State, and Federal Laws.

  15. Definition of Civil in nature: Violations against a person not fitting under law, but offensive and violating personal rights of privilege such as; using vulgar language in public, being rude, being belligerent, being disrespectful to person or property, disputes of damage/owing money for services performed, breech of contractual situations, etc...

  16. Explain the Offense in Detail (Include names, dates, times and pertinent information to the offense)

  17. If Yes please provide Witness Information

  18. Note: Selecting Yes will not make any difference in the preliminary investigation and the preliminary investigation will proceed in a timely, appropriate, and unbiased manner. If the reported complaint is found to be a criminal act, Anonymity only is for the preliminary investigation into the accusation. By constitutional law under the 6th Amendment the Accused has the right to face the Accuser if the proceedings find the accused accountable for their actions. If the reported complaint is found to be a civil matter, the Anonymity can continue throughout the process.

  19. Note: Selecting Yes will not make any difference in the preliminary investigation and the preliminary investigation will proceed in a timely, appropriate, and unbiased manner. If the reported complaint is found to be a criminal act, Anonymity only is for the preliminary investigation into the accusation. By constitutional law under the 6th Amendment the Accused has the right to face the Accuser if the proceedings find the accused accountable for their actions. If the reported complaint is found to be a civil matter, the Anonymity can continue throughout the process.

  20. Note: Selecting Yes will not make any difference in the preliminary investigation and the preliminary investigation will proceed in a timely, appropriate, and unbiased manner. If the reported complaint is found to be a criminal act, Anonymity only is for the preliminary investigation into the accusation. By constitutional law under the 6th Amendment the Accused has the right to face the Accuser if the proceedings find the accused accountable for their actions. If the reported complaint is found to be a civil matter, the Anonymity can continue throughout the process.

  21. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  22. All of the above information is correct, accurate, true to the best of my knowledge, and electronically signed by me at this date and time.


  23. Leave This Blank:

  24. This field is not part of the form submission.