Complaint Form – Georgetown Police Department

To file a complaint with the Georgetown Police Department please fill out the form below:

"*" indicates required fields

Name of Complainant

First Last

Date of Birth

Phone

Address

Street Address City State ZIP Code

Name of Involved Employee*

Rank

Badge Number

Name of Involved Employee

Rank

Badge Number

Date of Incident

Time of Incident

Location of Incident*

Nature of Complaint*

Describe in your own words all details you consider necessary for the police department to investigate your complaint (use additional sheet if needed).

Name of Witness

First Last

Witness Phone

Address of Witness

Street Address City State ZIP Code

I understand that I will be informed of the results of the police investigation and disposition of my complaint. Please pick one: I (am) / (am not) willing to testify at any hearing relating to this complaint. I have read the above written statement and it is true and accurate to the best of my knowledge.*

I am

I am NOT

Signature of Complainant or Parent/Guardian (if minor)*

Please type your name

Signature of Witness*

Please type your name