POLICE USE OF FORCE
INCIDENT DOCUMENTATION FORM

Thank you for contacting the NAACP. This form is intended to collect information for statistical reporting purposes only. Information shared in this report will be analyzed and reported to the public and may inform NAACP policy and advocacy activities. The following is not intended and should not be interpreted as a contract of any nature, either stated or implied.

The information provided in this form will be used to advance the NAACP’s criminal justice efforts. By completing this form you acknowledge that your information will be shared with NAACP staff and associated volunteers.

Persons age 18 and younger are not permitted to complete this form. Youth who have experienced an incident of excessive force should contact an adult to complete this form on their behalf. Personal data collected on this form will remain confidential, and you will only be contacted if you indicate on this form that you would like for a representative to contact you.

Completed forms may also be emailed to naacppoliceproject@gmail.com or faxed to (410) 358-3385.

or mailed to:  
NAACP National Headquarters
Attn: Research & Advocacy Department
4805 Mt. Hope Drive
Baltimore, MD 21215

Consent Statement:
I certify that I am at least 18 years old and understand that this report is intended to collect information only. I understand that NAACP staff and associated volunteers will have access to my complaint. I declare that the information being reported herein is true and correct to the best of my knowledge and belief.

The following questionnaire should take between 10-15 minutes to complete. Please take a moment to complete this form as completely as possible.