If You Have Received A Traffic Ticket You MUST File A Complaint Against The Officer.

Instructions For Filling Out This Form:

This Form Is For A Certified Complaint.

After Filling Out The Form On The Right,
You Can Save The Pre-Printed Form That Appears.

A Copy That Can Be Printed And Notarized Will
Also Be Sent To Your EMail Address.

To Complete The Process You Must Have The Printed Form Notarized, And Mail A Copy Directly To The Department.
Keep The Individual For Your Records.

There Is No Fee To Prepare And Record The Complaint. For $10.00 We Will Provide Follow Up Service. Please See The Instructions Below Before Purchasing.

After Filling Out The Form On The Right You Will Receive A Complaint Certification Number.

Please Make Sure To Write It Down.

Enter That Number In The PayPal Box Below And Click "Buy Now"
To Purchase Follow Up Service.

Enter Complaint Number:

Use This Form To Put A Certified Complaint Against
An Officer In Our Database
These Complaints Will Be Filed With The Department.

This Is A FREE Certified Complaint. It Can Be Printed And Notarized.
Printed Copies Will Be Filed With The Department, And A Record Made.

There is No Automatic Follow Up On This Complaint.
These Are For Record Purposes.
If You Need This Complaint Investigated Or Followed Up On,
Please Pay The $10.00 Follow Up Fee.

Officers Name Badge Number
Department County
State Date of Incident
Time Of Incident Location Of Incident
Your Name Your E-Mail Address
Details Of Incident