Canonsburg Police Complaint Form
This complaint form is for NON-EMERGENCIES only! For emergencies, please dial 911.
Type of Complaint
Date Occurred
Date of Report
Place of Offense
Name (Optional)
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Would you like to receive a call back from an officer?
Yes
No
When is the best time to contact you?
Please list any witnesses:
Please list any vehicles involved:
(Make/model, color, license plate number)
Summary:
Please summarize the nature and history of your complaint and provide any additional details that you feel are relevant
Submit
Should be Empty: