Commendation/Complaint Report Form - Melrose Police Department

Download the Commendation/Complaint Form here.

"*" indicates required fields

Citizen's Name*

First Last

Home Phone*

Daytime Phone (If Different)

Email Address

Address*

Street Address Address Line 2 City State ZIP Code

Date of Birth*

Social Security Number

Sex

Occupation

Employer

Employer's Phone

Type of Report*

Commendation

Complaint

Incident Date*

Incident Time*

:

Incident Location*

Incident Number (If Known)

Officer's Name*

2nd Officer's Name (If Applicable)

3rd Officer's Name (If Applicable)

Witness Name

Witness Phone

Witness Address

Street Address Address Line 2 City State ZIP Code

Witness Name

Witness Phone

Witness Address

Street Address Address Line 2 City State ZIP Code

Describe Basis for Commendation or Complaint (Attach Additional Statement, If Necessary)*