Fillable Form 1342 Steps For Submitting A Complaint/Compliment Via Email (Town of Chevy Chase Village)

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Form 1342 Steps For Submitting A Complaint/Compliment Via Email (Town of Chevy Chase Village)

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The Form 1342 Steps For Submitting A Complaint/Compliment Via Email (Town of Chevy Chase Village) form is 3 pages long and contains:

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  • 2 check-boxes
  • 26 other fields

Country of origin: US
File type: PDF

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Steps for Submitting a Complaint/Compliment via Email
1. Scroll down and fill out the information directly on the Compliment/Complaint Form.
2. Click on the File drop down menu in the upper left hand corner of the screen and click
“Save As.”
3. Select the location where you would like to save the form and type a file name in the box
marked “File Name” on the bottom middle of the window and then click “Save.”
4. To submit the completed form open your preferred e-mail program and enter
John.Fizgerald2@montgomerycountymd.gov in the “To” address.
5. Attach the form you completed and saved to your computer.
6. Send your email. Chief Fitzgerald or his representative will contact you.
11/2016
Oce Use Only Date/Time Received:________________ Inials & ID:__________
CCV 406
Chevy Chase Village Police Department
5906 Connecticut Avenue, Chevy Chase, Maryland 20815
(301) 654-7300
Compliment/Complaint Form
Instructions:
1. Fill out form. Please print or type legibly.
2. Complaints alleging excessive force must be signed and sworn to under penalty of perjury.
3. Submit/mail this form to 5906 Connecticut Avenue, Chevy Chase, Maryland 20815.
4. You will be contacted upon receipt of the Compliment/Complaint form.
Your Name:
Date:
Gender:
Race:
Home Phone:
Cell Phone:
Address:
Apt. Number:
City:
State:
Zip Code:
Location or address where incident occurred:
Date of Incident:
Time:
Incident# (if known):
1.Witness’ Name:
Phone Number:
2.Witness’ Name:
Phone Number:
Name(s) of employee(s) involved:
Describe what happened:
Please use reverse side of this form if more space is needed.
Signature:
Check One:
Compliment ☐ Complaint ☐
11/2016
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Form 1342 Steps For Submitting A ComplaintCompliment Via Email (Town of Chevy Chase Village)

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Completed 6 August 2020

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