GPD Complaint Form

GPD Complaint Form

Greensboro Police Department
Anyone who submits a form should be aware that in accordance with the North Carolina Public Records law, found in North Carolina General Statutes Chapter 132, their e-mail address is considered public record.

Need help with the form?

Samiyah Lewis, Criminal Justice Administrator with Greensboro Criminal Justice Advisory Commission (GCJAC), can assist with both completing and submitting the GPD form with you.

Contact or schedule appointment with Samiyah Lewis by e-mail or call 336-944-5412.

Office Hours
8 am - 5 pm, Monday through Friday

Office Location
300 W. Washington St
Plaza Level, Room 128
Greensboro, NC 27401
Full name*
Full Name*

First NameMiddle Name (type 'none' if no middle name)Last Name
Mailing address*

Street Address

Address Line 2

CityState

Zip Code
Phone number (provide at least one)
E-mail address
optional
Name and phone number of someone who can contact you if the City cannot reach you
Date and time of incident

MonthDayYear
DateHourMinutesAM/PM Option
Location of incident
Names of employees involved in incident or badge number(s) if known
Name(s) and phone number(s) of witness/witnesses
Reason for your complaint (select one)

Biased-based policing (race, color, religion, sex, handicap, familial status or national origin)Use of excessive forceRude or discourteous behaviorOther
Describe the incident using as much detail as possible
Describe the reason for your complaint
Please use as much detail about the incident as possible
Should be Empty: