Citizen Complaint Form

The Newburyport Police Department is committed to providing law enforcement services that are fair, effective, and impartially applied. A relationship of trust and confidence between the employees of the Newburyport Police Department and the citizens of the community is essential to the successful accomplishment of law enforcement objectives. It is in the best interest of everyone that your complaint about the performance of an individual is resolved fairly and promptly. The Newburyport Police Department has procedures for investigating your complaint. These procedures ensure fairness and protect the rights of both the citizens and the officers.

• You will complete the form below or download a printable form, which can either be mailed or dropped off to the following address: Newburyport Police Department, 4 Green Street, Newburyport, MA 01950.
• Your complaint will be reviewed and assigned to a Newburyport Police Department supervisor to investigate.
• You may be contacted by the investigating supervisor, in order to be clear on the details of your complaint.
• If the outcome reveals that a crime occurred, the District Attorney’s Office will be notified and/or consulted with, and you may be required to testify in court.
• Based on the nature and severity of the complaint, the Peace Officer Standards and Training Commission may be contacted as required by Massachusetts General Law.
• If the investigation results in an officer being charged with a violation of departmental rules and regulations or policies and procedures, you may be asked to testify in a departmental hearing.
• If the investigation shows that the complaint is unfounded or not sustained, or that the officer acted properly, the matter will be considered closed.

It is unlawful to provide information in this matter which you do not believe is true.

Citizen Complaint Form

Complainant’s Information(Required)

Last Name First Name

Home Phone(Required)

Cell Phone(Required)

Email(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Social Security Number(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Officer Complained Against(Required)

Rank(Required)

Car #(Required)

Officer Complained Against

Rank

Car #

Officer Complained Against

Rank

Car #

Incident Information(Required)

MM slash DD slash YYYY

Date

Time of the Incident(Required)

Location of the Incident(Required)

Description of the Incident(Required)

Signature of Complainant(Required)

I have read this complaint report, and I truly declare that the statements contained herein are accurate, true, and complete to the best of my knowledge and belief.

Date(Required)

MM slash DD slash YYYY

Signature of Complainant’s Parent/Guardian (if under 18)

Date

MM slash DD slash YYYY

Willing to Testify(Required)

I am willing to testify at any hearing in connection with this complaint and the subsequent investigation that will follow.

I am not willing to testify at any hearing in connection with this complaint and the subsequent investigation that will follow

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