Personnel Complaint Form
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2ARLINGTON COUNTY POLICE DEPARTMENT
PERSONNEL COMPLAINT FORM
Arlington County Police Department
Internal Affairs Section
1425 N. Courthouse Road
Arlington, VA 22201
The Arlington County Police Department will investigate any reasonable allegation of
misconduct by any of its members upon receipt of this form, properly executed and signed.
The use of this form is a necessary prerequisite to the investigation of a complaint
alleging misconduct.
The Department does not condone misconduct by any of its members
and will take appropriate action against any members found to be guilty of such
misconduct.
This completed form should be mailed to the address stated above.
Complete the following items fully.
Your Full Name __________________________________________________________________________
Your Street Address _____________________________________________________ Apt. No. ______
County or City ______________________________________ State __________ Zip Code _________
Home Telephone Number _______________________________ Work ______________________________
Date of Incident _____________________________ Time of Incident _________________________
Name of Officer(s) ______________________________________________________________________
Description of Officer(s), if name not known:
Race:_________________ Sex:____ Age:___ Ht:_____ Wt:____ Dress (uniform or plain clothes)
Identifying Characteristics _____________________________________________________________
_________________________________________________________________________________________
Officer’s vehicle number or description (If name not known) _____________________________
_________________________________________________________________________________________
State your specific complaint(s) and explain the circumstances, giving relevant facts
known to you.
You may continue on the reverse or attach more sheets.
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Parent category: Legal