Report a Law Enforcement Encounter

Please use this form to report bad encounters with law enforcement — including police, sheriff’s deputies, and correctional officers.

Name of Person Making Complaint(Required)

First Last

Email(Required)

Phone(Required)

Name of Victim of Law Enforcement Harassment(Required)

First Last

Address/Description of Location(Required)

Date(Required)

Time(Required)

Department that Committed Action

Officer Name(s)

First

Last

Officer Badge Number(s)

Physical Description of Officers

What Occurred (Narrative)(Required)

Are There Criminal Charges Pending Against Victim of Law Enforcement Harassment?(Required)

Yes

Was There a Use of Force?(Required)

Yes

Please Describe the Force Used(Required)

Was the Victim of Law Enforcement Harassment Injured?(Required)

Yes

Please Describe Injury(Required)

Did the Victim of Law Enforcement Harassment File A Grievance?(Required)

Yes

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