Arlington Police Department
Online
Citizen Complaint Report

 
     

You may remain anonymous.  If you wish to be contacted please provide an email or phone number.

 Mo  Day  Year   Email (Optional)

  

Your Name

Date of Birth

 

 

Your Address

Home Phone

 

Your Employer

Business Phone

Date/Time of Incident

 Address Where Incident Occurred

Name, if known, of Arlington Police employee(s) you are complaining about:

1.

2.

3.

4.

If name is not known, describe the Police employee(s) you are complaining about:

 
Police car number:    
Have you reported this to other officers? Yes   No If so, whom?
Did you receive a citation(s)? Yes   No Number and reason?
Were you arrested? Yes   No Reason?
Do you have a police report number for this incident? Yes   No Number?

Persons who actually saw the event, including yourself:

Name

Address

Phone

 

 

 

 

 

Summary of Event:

 

PLEASE READ BEFORE SUBMITTING
I understand that it is a violation to willfully make a false report.  In the event this report is proven false, the information may be provided to the District Attorney or City Prosecutor for possible prosecution.

By clicking the submit button I certify that the statements in this form are true.

 
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