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THE
CITY
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BURLINGTON
MAYOR
DEPARTMENTS
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VIEW DIRECTORY
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Burlington Police Department Online Citizen Complaint Form
Citizen Information
Do you wish to remain anonymous?
Yes
No
If you choose to remain anonymous, we will not be able to follow up with you regarding your submission.
Would you be willing to meet in person to discuss this incident?
*
Yes
No
Would you consider mediation as a way to resolve this incident?
*
Yes
No
Name
*
Address
Primary Contact Number
*
Alternate Contact Phone Number
Email address
Date of Birth
Year
Year
1900
1901
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2050
Month
Month
Jan
Feb
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Day
Day
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Age
*
Gender
*
Female
Male
Non-binary/third gender
Transgender
Prefer not to say
Prefer to self-describe
Describe
*
Race/Ethnicity
*
Asian/Pacific Islander
Black/African American
Hispanic/Latinx
Native American
White/Caucasian
Other
Other
*
Incident Details
Incident Date
*
Year
Year
2023
2024
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
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31
Approximate Time
Hour
Hour
1
2
3
4
5
6
7
8
9
10
11
12
:
Minute
Minute
00
01
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59
am
pm
Incident Location
*
Enter the address or nearest intersection where the incident took place
Officer(s) Involved
*
Enter the name(s) and/or badge number(s) of officer(s) involved. If unknown, enter physical description.
Complaint Category
*
- Select -
Force—whether extent and/or use of force was justified
Abuse of Authority—racial profiling or other biased policing, unauthorized search/seizure, inappropriate entry onto property
Discourtesy—rude or unprofessional manner, rude or offensive gestures, or general profanity
Offensive Language—language degrading on basis of ethnicity, race, sex, sexual orientation, or any other protected class
Other Department Violation—other violation that is breach of Department Directives not fitting into above categories
Select the category you feel best describes the alleged behavior.
Description of Incident
*
Witnesses to Incident
Were there witnesses to the incident?
*
Yes
No
Witness 1 Information
Witness 1 Name
Witness 1 Address
Witness 1 Phone Number
Witness 2 Information
Witness 2 Name
Witness 2 Address
Witness 2 Phone Number
Witness 3 Information
Witness 3 Name
Witness 3 Address
Witness 3 Phone Number
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Contact
BPD
Burlington Police Department
Antonio B. Pomerleau Building
One North Avenue
Burlington, VT 05401
Phone: 802-658-2700
Emergency: Dial 911
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