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Code Enforcement Complaint Form

Steps

1. Step One This section is complete This section is incomplete
2. Reporting Party's information This section is complete This section is incomplete
3. Event Information This section is complete This section is incomplete
4. Vehicles involved This section is complete This section is incomplete
5. Upload Related Images This section is complete This section is incomplete
6. Official Statement This section is complete This section is incomplete
7. Submittal of Report This section is complete This section is incomplete

Step One

Bixby Police Department
Official Code Enforcement Complaint Form
Notice
By Submitting this form, you are making a formal complaint with the Bixby Police Department and the Bixby Code Enforcement Officer. You could be called to testify by a subpoena in a Court of Law as a the Complaining Party.
Do You Understand the Notice Above and Agree to Testify in a Court of Law if called by a Subpoena?*
If You Do Not Agree then Do Not submit The Formal Complaint.
1. Yes, I agree
Continue

Reporting Party's information

First Name *
Middle Name*
Last Name*
Address*
City*
State*
Zip Code*
Date of Birth*
Date of Birth
Driver's License*
License State*
Phone Number*
Cell Phone Number
Email Address*
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Event Information

Type of Crime/Event*
Other Violation Explained*
Address Where the Complaint Located*
City*
Zip Code*
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Vehicles involved

Is a Vehicle Involved?*
1. Yes
2. No
Make*
Model*
Year
Color*
License Plate Number*
If No Tag is Displayed Enter None
License State/Tribe*
If there is No Tag is Displayed Enter None
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Upload Related Images

Do you have any pictures of the issue?*
1. Yes
2. No
Picture #1*
#2
#3
#4
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Official Statement

Explanation and Time Line of Events. Please Reference Related Uploaded Images If Appicable*
NOTICE:TITLE 21, CRIMES & PUNISHMENT SECTION 491 – PERJURY DEFINED Every person who having an oath that he/she will testify, declare, depose, or certify truly before any competent tribunal, officer, or person, in any of the cause in which such an oath may by law be administered, willfully and contrary.
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Submittal of Report

By signing with my Electronic Signature below and submitting this form to the Bixby Police Department and the Code Enforcement Officer , I acknowledge the above report and statement was made voluntarily by me. I have read it, and to the best to my knowledge it is true and correct. It contains nothing that is not true.
Electronic Signature*
(Full Legal Name)

Leave This Blank:

1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
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Code Enforcement Complaint Form

Steps

Step One

Reporting Party's information

Event Information

Vehicles involved

Upload Related Images

Official Statement

Submittal of Report

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