Form COL Violation Warning Denial of Rights Under Color of Law
u Violation Warning—18 U.S.C. §242; 18 U.S.C. §245; 42 U.S.C. §1983
Name and address of Citizen Name and address of Notice Recipient
Citizen’s statement:
I certify that the forgoing information stated here is true and correct. Citizen’s signature
u Date
u Violation Warning—18 U.S.C. §242; 18 U.S.C. §245; 42 U.S.C. §1983
Name and address of Citizen Name and address of Notice Recipient
Citizen’s statement:
I certify that the forgoing information stated here is true and correct. Citizen’s signature
u Date