Submit Complaint or Compliment

Enter your information:

Fields marked with asterisk (*) are required. Format phone numbers as 777-777-7777.

Last Name*First Name*MI*

Street Address*City* State* Zip*

Home Phone* Work Phone Cell Phone

Email Address*

Enter the name and/or description of the Sheriff's Office employee(s):

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State your specific commendation or complaint and explain the circumstances, giving the relevant facts known to you:

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Location

Date (mm/dd/yyyy) Time (hh:mm a.m./p.m.)

Enter information about witness(es):

Witness 1

Last Name First Name

Street AddressCity State Zip

Home Phone Work Phone Cell Phone

Witness 2

Last NameFirst Name

Street AddressCity State Zip

Home Phone Work PhoneCell Phone

Witness 3

Last NameFirst Name

Street AddressCityState Zip

Home PhoneWork Phone Cell Phone

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 understand that any false or misleading statements, accusations or allegations made by me in relation to this report either orally or in writing, may subject me to civil action and/or criminal prosecution.

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 Sheriff's Office for the purpose of discussing the incident in detail. I further understand that if an awards board hearing, 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)

The Virginia Freedom of Information Act (FOIA) provides residents of Virginia and representatives of certain news organizations with a right to inspect and copy many public records held by the Fairfax County Sheriff's Office. Your providing the requested information will result in the creation of a public record that may be subject to such disclosure. Depending on the particular facts and circumstances, your particular record may be exempt from disclosure under FOIA. However, whether or not the particular record is exempt or subject to disclosure, you may ask that the personal information that you are now providing to the Sheriff's Office not be disclosed pursuant to requests from such residents and news organizations. Please advise us whether the personal information that you are providing with this request should or should not be made available to such residents and news organizations.

Yes, withhold my personal information from responses to FOIA requests made by residents and news organizations.

No, do not withhold my personal information from responses to FOIA requests made by residents and news organizations.