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Police Complaint / Commendation Form

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Steps

1. Complaint or Commendation Section This section is complete This section is incomplete
2. Section on Police Brutality This section is complete This section is incomplete

Complaint or Commendation Section

Purpose*
1. Commendation of Employee Service
2. Complaint of Agency Action
3. Commendation or Suggestion Regarding Agency Service
4. Complaint of Employee Performance
Date
Date
Your Name
First, Last and Middle
Email Address
Work Address
City
State
Zip Code
Phone Number
Best Location / Way to Contact You:*
Date and Time Incident Occurred:
Date and Time Incident Occurred:
Date and Time Incident Occurred:
Incident Location or Address
City
State
Zip Code
Employee(s) / Officer(s) involved (if known):
1. Employee(s) / Officer(s) Name and ID Number
2. Employee(s) / Officer(s) Name and ID Number
3. Employee(s) / Officer(s) Name and ID Number
4. Employee(s) / Officer(s) Name and ID Number
Witnesses to incident
1. Name
Address
City
State
Zip Code
Phone Number
2. Name
Address
City
State
Zip Code
Phone Number
3. Name
Email Address
Address
City
State
Zip Code
Phone Number
Fax Number
4. Name
Email Address
Address
City
State
Zip Code
Phone Number
Fax Number
Best way to locate witness(es)
Your Experience in Your Own Words
Please provide us with detailed information regarding this matter in your own words.
eSignature
By typing your name, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
Date
Date
Date
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Section on Police Brutality

This Section Only Applies to Complaints of Police Brutality
County
Date
Date
Oath made to District Commissioner or Notary Public
I hereby certify that on the date provided, I appeared before a district commissioner or notary public of the State of Maryland and the County submitted, and made an oath in due form of the law that the matters and facts provided in a case of police brutality are true.
District Commissioner / Notary Public Name
Commissioner or Notary Commission Expires: