Citizen Complaint Form - Fairfax County, Virginia

Citizen Complaint Form

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CITIZEN COMPLAINT FORM
Fairfax County Police Department
4100 Chain Bridge Road
Fairfax, VA 22030

The Fairfax County Police Department aggressively investigates all allegations of misconduct lodged against officers and other employees of the agency. The purpose of these investigations is to determine and examine all facts and circumstances relevant to the incident in question. Should such allegations be sustained as a result of the investigation, appropriate actions will be taken to prevent a future occurrence of the conduct.

This form is used to file a complaint regarding an officer's or other employee's conduct or to express dissatisfaction with a policy, procedure, practice, or level of service provided by the department. If you wish to report a crime or file a police report please click here.

Please enter your information (Labels in red are required information.)

Last Name	First Name	M. I.
Street Address	City	State Zip Code
Home Phone Number (703-999-9999)	Work Phone Number (703-999-9999)
E-Mail Address

Please enter witnesses information

Witness 1:
Last Name	First Name	M. I.		Home Phone #
Street Address	City	State	Zip Code	Work Phone #
Witness 2:
Last Name	First Name	M. I.		Home Phone #
Street Address	City	State	Zip Code	Work Phone #
Witness 3:
Last Name	First Name	M. I.		Home Phone #
Street Address	City	State	Zip Code	Work Phone #

Please enter the officer(s)/employee(s) names and/or descriptions

Please enter the incident information

Location of Incident	Date of Incident (mm/dd/yyyy)	Time of Incident (hh:mm)
State your specific complaint(s) and explain the circumstances, giving the relevant facts known to you.

Affirmation I, , do hereby affirm that the foregoing information provided by me is true and complete to the best of my knowledge and belief. I realize that to assure a thorough investigation of this matter, it may become necessary for me to meet with representatives of the Fairfax County Police Department for the purpose of discussing the incident in detail. I further understand that if a trial board hearing, court hearing or civil service commission hearing results from this investigation, my presence and testimony at such hearing may become necessary. I hereby agree to make myself available at reasonable times and places as may be necessary for such interviews and/or hearings. Reported on . (Enter today's date as mm/dd/yyyy)