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File a Complaint Against an Officer

Steps

1. Step One This section is complete This section is incomplete
2. Employee(s) Involved This section is complete This section is incomplete
3. Witnesses This section is complete This section is incomplete
4. Incident This section is complete This section is incomplete

Step One

First Name*
Last Name*
Address*
City*
State*
Zip*
Email*
Phone*
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Employee(s) Involved

Name
Badge Number
Name
Badge Number
Name
Badge Number
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Witnesses

Name
Phone
Name
Phone
Name
Phone
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Incident

Location of Incident*
Date Occurred*
Time Occurred*
Please describe the incident:*
Complainant's Affirmation
I do solemnly swear that the above information is true to the best of my knowledge. I understand that based on this complaint, an investigation will be conducted and that if substantiated, appropriate action will be taken. I further understand that if the investigation proves the allegations were known by me to have been false when the complaint was signed that the accused Burlington Police Department employee (s) may pursue legal remedies against me.
Please Choose
1. I have read and affirmed
2. I have read and DO NOT affirm

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File a Complaint Against an Officer

Steps

Step One

Employee(s) Involved

Witnesses

Incident

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