Law Enforcement Encounter Report | Beaver Island Association

Name *

First

Last

Email *

I'm providing a report about:

Encounter with law enforcement officer(s)
Personal behavior resulting from concerns about enforcement
Another public safety concern

Please indicate the date and time of the encounter *

Date

Time

Where did the encounter occur? *

What reason or reasons were you given by the officer(s) for the encounter? *

If no reason was given, please indicate that.

Please provide a factual description of the encounter *

Please be objective and refrain from providing your opinion about conduct. This will provide the most useful information to address your concerns.

If you have a recording, picture or documents concerning the encounter that you are willing to share, please upload them here…

Click or drag files to this area to upload. You can upload up to 3 files.

Please describe how you modified your behavior in response to reports about the conduct of law enforcement officers or others on the island *

Please be as objective as possible. Report what you heard or read that caused the change in your behavior and how you reacted. Please provide information about the date(s), time(s), location(s) and circumstances involved in your concern. The community is particularly concerned if you avoid a trip into town to participate in community activities, to shop or eat as a result of your concerns. It is important that people feel safe on the island and feel free to enjoy activities.

If you have video, pictures or documents that illustrate your concern and would like to share them, please upload them here…

Click or drag files to this area to upload. You can upload up to 3 files.

Please provide information about your public safety concern *

Please the facts that give rise to your concern including relevant details such as dates and times of incidents or observations.

You may provide additional contact information here, but it is not required. To complete and submit the form, please please indicate your consent to the use of your information and then click the SUBMIT button below. You will see a confirmation message when your submission is complete. You may then close this page.

Phone Number

Address

Address Line 1

Address Line 2

City

State

Zip Code

Consent *

I conset to the use of the information in this form by St. James Township and its designees.

By checking the box above and clicking the SUBMIT button below you (i) certify that you are at least 18 years old and (ii) indicate your consent for St. James Township to use and disclose this information in connection with its efforts to address concerns about and improve relations with law enforcement and other officials on the island. You also understand and agree that the Beaver Island Association is and may process and store the information you submit as directed by St. James Township. Your consent is required to submit this form.