Police Services Comments Date of contact with employee Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20152016201720182019 Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Location of contact (i.e., address, cross streets, etc.) Employee’s name, (if known) What initiated your contact with the employee? Police response to your call Pick up property Witness Traffic Stop Traffic Collision Made a report at the police station Other Other What would you like to commend about the employee’s performance? Name Address Phone Number
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