Citizen Complaint Form

2. Citizens may file a complaint about Police Department personnel on this form. You may hand-deliver or mail the completed form to the Pelham Police Department, Office of the Chief of Police, 14 Village Green, Pelham, NH 03076. The form can also be emailed to our administration office.

   Downloadable Form Here

   Information

   Please provide as much information about the reason you had contact with the officer/employee. Specific information about the date, time, and location will help in locating the information if you do not know the officer/employee’s name.

4. Involved Officer/Employee(s) Information:*
5. 2nd Involved Officer/Employee(s) Information:
7. Person Making the Complaints Name:
8. Person Making the Complaints Phone Number:
10. Person Making the Complaints Address:
12. City:
13. State:
14. Zip Code:
16. Date / Time of Contact:*
    Date / Time of Contact:

    Date / Time of Contact:
17. Location:
19. Reason for the Complaint: *
21. WITNESS #1 Full name and Phone Number
23. WITNESS #2 Full name and Phone Number
25. WITNESS #3 Full name and Phone Number
27. Submitted by:*
28. Submitted Date:*
    Submitted Date:
30. Email Address:*
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field