Border Patrol Misconduct Report

Note: Be as accurate and detailed as you can (and don’t guess!).  If you have any questions about filling out this form, contact us at noborderscamp@gmail.com or noborderslegal@riseup.net.  NOTE:  This form will open differently in different programs;  feel free to adjust so that it makes sense and can be filled out fully.  Thank you.  
  
	Today’s Date:
Your Name:			Email:				Phone:			Address:




Date, time and exact location of the incident (include cross streets as well as street address and any landmarks):




Victim 1:
Name:	Email:
Phone:			Address:
Description of victim (include gender, race, age, height, weight, build, clothing, glasses, hair color/style, etc.)  Be as detailed as possible:






Victim 2:
Name:	Email:
Phone:			Address:
Description of victim (include gender, race, age, height, weight, build, clothing, glasses, hair color/style, etc.)  Be as detailed as possible:









Officer 1:
Name:	Badge #:
Organization:	Rank:
Vehicle type:      	Vehicle #:
License Plate #:
Description of officer (include gender, race, age, height, weight, clothing and insignia, hair color/style, weapons, vehicle, etc.)  Be as detailed as possible:








Officer 2:
Name:	Badge #:
Organization:	Rank:
Vehicle type:      	Vehicle #:
License Plate #:
Description of officer (include gender, race, age, height, weight, clothing and insignia, hair color/style, weapons, vehicle, etc.)  Be as detailed as possible:







			
Witness 1:
Name:	Email:
Phone:			Address:
Media affiliation (if any):
Description of witness.  Be as detailed as possible:







Witness 2:
Name:	Email:
Phone:			Address:
Media affiliation (if any):
Description of witness.  Be as detailed as possible:







Describe the incident.  Include what lead up to the incident.  Be as detailed as possible. 


Things to look for:
 - How the police and civilians were acting (e.g. aggressive, scared) 
 - Why police arrived/were present
 - Offensive language or hate speech (e.g. racist, sexist, homophobic) by cops  
 - Rude language or swearing by cops 
 - Searches of person, bag, car, or home, pat downs, stops, inappropriate questioning etc. and what was said
 - Any violence (be specific)
 - What type of physical force, what type of weapons (e.g. Shove, punch, nightstick, pepper spray)
 - How many times and on what parts of the body did the officer strike
 - Was victim cuffed or being held down
 - Any property damaged or taken
 - Injuries – describe number, type and location (e.g., two baseball-sized bruise on back)
 - Info on ambulance and medics (license plate #, names and ID #s)
 - Hospital where treatment was obtained