IMPORTANT: This form may be used to report any incidents of police brutality as well as police officer misconduct. These incidents may be brutality or misconduct that you have experienced yourself or that you know of happening to someone else. In order for your report to be considered for inclusion on our national list of law enforcement officers involved in officer misconduct and police brutality, the following form must be filled out completely and to the best of your ability. Any missing information will greatly reduce the chance that your report will be included on our national list of police misconduct and police brutality. False, improper and intentionally deceptive information, as well as vulgar language, angry rants and missing contact information will eliminate any chance of this report being included on our national list of officers. You may create one report per incident. Multiple officers may be named on one form if all were involved in the same incident.

Victim Information:

IMPORTANT: Contact information is required in case we have any questions, or in some cases, to get additional information. We need the other requested information below in order to substantiate your claim, categorize your event and place your incident properly on our map and on our comprehensive list. NONE of your personal information on this form will be made publicly available or given to a third party.