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This document is an internal incident report form, provided in Vietnamese, intended for documenting complaints or incidents, specifically those potentially involving police officers. The form requests comprehensive details from the reporter, including their contact information, a description of the incident, information about any accused officers (name, badge number), and the location and date/time of the event. It also asks how the report was submitted (e.g., in person, phone, email), whether evidence was provided, and if the incident had been previously reported. The form includes dedicated sections for the receiving officer and supervisor to record their details and review the complaint.