Complainant Information
Date of Birth (YYYY-MM-DD)
Street Address or Post Office Box (Required)
City (Required)
Province (Canada) (Required)
Please Select
AB
BC
YK
NT
NU
MB
ON
SK
NB
QC
PE
NL
NS
N/A
Postal Code / ZIP Code (Required)
Country (Required)
Telephone number where you can be reached (999-999-9999) (Required)
E-mail Address (yourname@domain.com)
Questions
Preferred Language of Correspondence (Required)
Please Select
English
French
Preferred method of communication (Required)
Please Select
E-Mail
Phone
Mail
Were you the person involved in the incident being complained of? (Required)
Please Select
No
Yes
If you were given a file number by the RCMP with respect to the incident, please provide it (if known)
Have you previously filed an official public complaint about this incident with the CRCC or the RCMP for which you were provided with a public complaint record/file number? (Required)
Please Select
No
Yes
If yes, did you sign an agreement with the RCMP to resolve this complaint informally? (Required)
Please Select
No
Yes
Details of Complaint (complete as much as possible)
Time of Incident (approx.)
00:00
00:15
00:30
00:45
01:00
01:15
01:30
01:45
02:00
02:15
02:30
02:45
03:00
03:15
03:30
03:45
04:00
04:15
04:30
04:45
05:00
05:15
05:30
05:45
06:00
06:15
06:30
06:45
07:00
07:15
07:30
07:45
08:00
08:15
08:30
08:45
09:00
09:15
09:30
09:45
10:00
10:15
10:30
10:45
11:00
11:15
11:30
11:45
12:00
12:15
12:30
12:45
13:00
13:15
13:30
13:45
14:00
14:15
14:30
14:45
15:00
15:15
15:30
15:45
16:00
16:15
16:30
16:45
17:00
17:15
17:30
17:45
18:00
18:15
18:30
18:45
19:00
19:15
19:30
19:45
20:00
20:15
20:30
20:45
21:00
21:15
21:30
21:45
22:00
22:15
22:30
22:45
23:00
23:15
23:30
23:45
Province (Required)
Please Select
AB
BC
YK
NT
NU
MB
ON
SK
NB
QC
PE
NL
NS
N/A
Location (city, town)
Please provide, if possible, the name, rank and detachment of the RCMP member(s) whose behavior you are complaining about. If you do not know the name, please provide a description and the number of members you are complaining about. Please ensure that the details of the specific misconduct of any members you list here are included in the section below.
Please provide the name(s) of any witness(es), if applicable. Witnesses may include RCMP members you are not complaining about.
Privacy & Disclosure of Personal Information
By submitting a completed complaint form, you are authorizing the Commission to collect your personal information for the purposes related to Parts VI, VII, VII.1 and VII.2 of the RCMP Act. This information is held in personal information bank CRCC PPU 005, and you have a right to access this information in accordance with the Privacy Act .
Completed public complaint forms, along with all other relevant documentation you provide to the Commission, will be forwarded to the RCMP for investigation pursuant to subsection 45.53(10) of the RCMP Act and an RCMP complaint investigator may contact you to provide a statement.
Acknowledgement
I have reviewed this public complaint form and the information I have provided is true and complete to the best of my knowledge.
By clicking this box, you are acknowledging that the information provided is complete and accurate to the best of your knowledge. (Required)