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� <br />CITIZEN COPSPLAIhP {�ORKFHEET <br />Date: �/� ���8 r= • Taken by: L-.• C�,4-L.l�/Jki..cl�l1 <br />, � . <br />Complainant's name: /�/f/Z, .�f� (�L. �� <br />Complainant's address: <br />Complainant's phone: <br />Complaint concerning: �,v/� �a,,�rc�� !d% �J �� �5 <br />Problem: �U�� �iZ�..`� L.�. <br />� <br />• [�.� I.' �/ � I rL�� � r. <br />� � C a� e ► - r '� w ► � r • <br />� J _ � �i i <br />•i t_• �i O _ <br />� C_. .�: � <br />Referred to:_ l�/%/�62..( pti.� I�_�-���', <br />ACTION TAI�EN <br />�� <br />