Prince George's County Office of Ethics and Accountability

Personal Information


*Anonymous?
*First Name
*Last Name
Middle Name
*Email
*Phone
Home Phone
Alternate Phone
*Street Address
*City
*Country
*State
*Zip Code
Best Time to Contact
Preferred Contact Channel

Complaint Details


*Type
Sub Type
*Government Employee/Official Name
Agency/Entity if known
*Approximate Date and Time of Alleged Event
*Approximate Location of Alleged Event
Any known witnesses or involved parties?
*Implicated Person Type
Implicated Person’s Telephone numbers
Implicated Person’s Home Address if known
Have you filed a complaint anywhere else? If Yes provide details.
*Reporter Type
Reporter Agency
*Complaint Description
*Do you consent to the release of your name during the course of investigative activities?

Electronic Signature


*
I hereby certify to the Office of Ethics and Accountability, under oath or affirmation and subject to penalties of perjury, that the statements in the foregoing Complaint, including any attachments, are true and correct to the best of my knowledge, information and belief, and that I am not making this Complaint in bad faith or for any improper purpose. I further agree that my use of computer, key pad, mouse or other device sign and or submit this Complaint constitutes my signature as if actually signed by me, is the legal equivalent of my manual signature, and constitutes my certification that the statements herein are true and accurate.

Attachments (Please attach if you have any documents relevant to your complaint)



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