Oriskany, NY · Oneida County
Personnel/Department Complaint Form
This form records a complaint about personnel or a department, with incident details, information about the people involved, and a sworn or affirmed statement from the complainant.
At a glance
- Issued by
- City of Oriskany · Oriskany, Oneida County, New York
- Notarization
- Required: sign this form in front of a notary before filing it.
- Official source
- oriskany.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
The form provides space to describe an incident, identify the personnel complained of, list witnesses, and give the complainant’s contact information. It includes a certification that the facts are true and correct, a warning about false statements, and a notary section for a sworn statement or affirmation. The form says to continue on an additional form if more space is needed and attach it.
Who needs it
A person submitting a complaint about personnel or a department can use this form to record the incident, identify involved personnel and witnesses, and provide a statement.
Why it needs a notary
The form includes a “Subscribed and sworn to before me” and an affirmation-under-penalty-of-perjury block; the complainant signs the statement before the notary.
How to get this notarized
- 1
Download the Form
Get the Personnel/Department Complaint Form from the City of Oriskany.
- 2
Fill In the Complaint
Enter the incident, complainant, personnel, and witness details. Attach an additional form if more space is needed.
- 3
Book an Online Notary
Arrange an online notarization for the form’s sworn statement or affirmation.
- 4
Sign on Video
Sign the statement during the online notary session as directed.
- 5
Submit to the City
Submit the completed form and any attachments to the appropriate city department.
Preview the form
The blank PDF straight from Oriskany. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I submit this complaint form?
- Complete the incident, complainant, personnel, and witness sections, then sign the sworn or affirmed statement before a notary. Submit the completed form to the appropriate city department.
- Do I need to sign this form in front of a notary?
- The form includes a “Subscribed and sworn to before me” section and an affirmation-under-penalty-of-perjury section. Sign the statement before the notary.
- Can I use an online notary for this form?
- New York authorizes remote online notarization by a commissioned online notary under Executive Law §135-c, effective in 2023. Confirm with the city, town or village if unsure.
- What if I need more room to describe the complaint?
- The form instructs complainants to continue on an additional form if more space is needed and attach it.