Rockdale – Complaint/Compliment CLAY COUNTY SHERIFF’S OFFICE MEMBER COMPLAINT FORM How do I submit a comment (positive or negative) about a CCSO employee or service? The Internal Affairs Section primarily handles serious complaints about Clay County Sheriff’s Office employees. Citizens can ask to speak to any on-duty CCSO supervisor directly at any time or call the Office of Internal Affairs at (904) 213-6039 Monday - Friday, 8 a.m. – 5 p.m., excluding holidays. Citizens may also obtain and complete the Citizen Comment Form at headquarters or the operations centers in Orange Park or Middleburg. You can fill out the form & submit it online, or print it out here & mail it to the following address: Clay County Sheriff’s Office Attn: Internal Affairs P. O. Box 548 Green Cove Springs, FL 32043 Incident or Event InformationWhat Happened?Location of Incident Date MM slash DD slash YYYY Time Explanation of Event:CCSO Member InformationName ID Race Sex Height Weight Approx Age In Uniform? Y N N/A Other Identifying Characteristics Vehicle or Tag Number Vehicle Model Vehicle DescriptionContact Information (Complainant)First Name MI Last Name Street Address City State Zip Race Sex DOB Home PhoneCell PhoneBusiness PhoneWitness Contact Information2First Name 2MI 2Last Name 2Street Address 2City 2State 2Zip 2Race 2Sex 2DOB 2Home Phone2Cell Phone2Business PhoneReviewReview*Please verify that the information is complete and accurate in order to submit the information to Internal Affairs. All information is true and correct to the best of my knowledge. Caution: Whoever knowingly makes a false statement in writing with the intent to mislead a public servant in the performance of his or her duty shall be guilty of a misdemeanor of the second degree as provided by Florida State Statutes 837.06, 775.082, 083, and 084. Further, if the charge(s) is found to be unfounded, the accused has the right to pursue civil recourse against the complainant.