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Welcome to the Montgomery County Police Accountability Complaint Form.

According to the Maryland Public Safety Code Ann. § 3-102, a complaint of police misconduct filed with a police accountability board shall include:
- The name of the police officer accused of misconduct;
- A description of the facts on which the complaint is based; and
- Contact information of the complainant or a person filing on behalf of the complainant for investigative follow-up.
A complaint of police misconduct with a police accountability board shall be forwarded to the appropriate law enforcement agency within 3 days after receipt by the board.
- Those filing complaints will receive follow-up from the appropriate law enforcement agency conducting the investigation.
The complainant’s contact information will not be shared with the officer in which the complaint is filed against.
After you have submitted your Complaint Form, you will be given instructions to download your submitted Form in PDF format.
- If you are unable to complete this form on-line:

Click here to print the PAB form and submit or mail this form to:
101 Monroe Street, 2nd Floor
Rockville, MD 20850
C/O: Earl Stoddard & Lindsay Bolt
For assistance, call MC311 by dialing 311 in the County or by dialing 240-777-0311.

Police Accountability Board Complaint Form

PAB Tracking

You will be provided with a PAB Tracking upon submission.

Demographics

Montgomery County does not discriminate or disqualify business applicants based on gender, race, religion, ethnicity, sexual orientation, gender identity, family status, country of origin, disability, or other demographic categories.

Complainant First Name

Complainant Last Name

Complainant Primary Number

Complainant Secondary Number

Complainant Email

Complainant Street Address

Complainant Street Address Line 2

Complainant City

Complainant State

Complainant Zip

Complainant Gender

If other, please tell us how you identify your gender

Complainant Ethnicity

Complainant Race

Place of Birth

Region of Origin

Incident Description

Is the Incident Date and Time actual or approximate

Actual

Approximate

Incident Hour

Incident Minutes

Incident AM/PM

Incident Type

Incident Location Name

Incident Street Address

Incident Street Address Line 2

Incident City

Incident State

Incident Zip

Incident # (if known)

Incident Description

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Law Enforcement Personnel Involved (If unknown, type Unknown)

Law Enforcement Personnel 1 First Name

Law Enforcement Personnel 1 Last Name

Badge Number 1 (if known)

Agency 1

You will be able to enter additional personnel in the next section.

Is there another Law Enforcement Personnel Involved

Law Enforcement Personnel Involved (If unknown, type Unknown)

Law Enforcement Personnel 2 First Name

Law Enforcement Personnel 2 Last Name

Badge Number 2 (if known)

Agency 2

Witness Information

Witness 1 First Name

Witness 1 Last Name

Witness 1 Phone Number

Witness 1 Street Address

Witness 1 Street Address Line 2

Witness 1 City

Witness 1 State

Witness 1 Zip

Is there another witness

Witness 2 First Name

Witness 2 Last Name

Witness 2 Phone Number

Witness 2 Street Address

Witness 2 Street Address Line 2

Witness 2 City

Witness 2 State

Witness 2 Zip

Additional Witness Information

Completing this on behalf of someone else

First Name

Last Name

Consent

Checking this box and submitting this form to the Police Accountability Board indicates that I have reviewed the information and certify it is true to the best of my knowledge.

Please verify you have entered all data as complete as possible before proceeding by clicking the Previous Button at the bottom right of this page.
Click the Submit Button only if you are certain that you want to submit your complaint.

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Agency Tracking Number

Method of Receipt

Complaint Status

PAB Staff First Name

PAB Staff Last Name

PAB Received Hour

PAB Received Minutes

PAB AM/PM