City of Butler, Indiana

Anyone can submit a commendation of appreciation for outstanding service to the community provided by a public employee. Complete this form and submit it by pressing the appropriate button at the bottom of this page. We also accept commendations submitted in written format.

All fields marked with * are required.

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YOUR INFORMATION

Name*

Address*

City, State & Zip Code:*

Home Phone*

Daytime Phone*

BUTLER POLICE DEPARTMENT EMPLOYEE(S) INFORMATION

1. Officer's Name

Badge #

2. Officer's Name

Badge #

3. Officer's Name

Badge #

4. Officer's Name

Badge #

Description if name(s) is/are unknown

INFORMATION ABOUT THE OCCURRENCE/EVENT

Location of Occurrence

Date of Occurrence

Description of Occurrence/Event

FOLLOW-UP (IF NECESSARY)

May we contact you?*

Yes

No