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Bentley University Police Department Civilian Complaint Report

Please fill out the form below to submit a complaint report. You may also download the form here and mail it to: Chief Ernest H. Leffler, Callahan Police Station, 175 Forest St. Waltham, MA 02452 or email it to

Incident Information
Complainant Information
Name or physical description, Badge #, Car #, etc.
Please Provide Answers to the Following Questions
Please provide a full description of the circumstances that prompted your complaint. Attach supporting documentation, as appropriate; including letters, e‐mails, photographs, videos or audio tapes, etc in the file upload segment below.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png bmp eps tif pict psd txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml avi mov mp3 ogg wav bz2 dmg gz jar rar sit tar zip.

I have read, or had read to me, the above and attached complaint and statement. All of the answers are true and accurate to my knowledge. I understand that making a false statement/report could result in being held criminally and/or civilly liable for knowingly filing a false complaint or making a false statement