Citizen Complaint Procedure Form

Any person who knowingly and willfully falsifies, conceals, or covers up by any trick, scheme, or device a material fact; makes a false, fictitious, or fraudulent statement or representation; or makes or uses any false writing or document, knowing the same to contain any false, fictitious, or fraudulent statement or entry, in any matter within the jurisdiction of any department or agency of state government or of the government of any county, city, or other political subdivision of this state shall, upon conviction thereof is guilty of a felony (O.C.G.A. 16-10-20).

Any person reporting to a peace officer an offense or incident within the officer’s concern knowing that the offense or incident did not occur; or a person making a report to a peace officer relating to an offense or incident within the officer’s concern, knowing that he/she has no information relating to the offense of incident, upon conviction thereof is guilty of a misdemeanor. (O.C.G.A. 16-10-26).

If you prefer you may download and submit a printable PDF of this form

Your Information


Witness 1 Information


Witness 2 Information


Additional Information


powered by finalsite