Complaint Form

To report a crime involving a person, business or location in Westchester County directly to the District Attorney’s Office, complete and submit the complaint form or call (914) 995-TIPS (914-995-8477).

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COVID-19 Update
To best protect the health and safety of our entire community during the pandemic, complaints to our office must be submitted either by e-mail or postal mail. Do not attempt to hand deliver your complaint at this time. Thank you for your understanding. Stay safe and stay healthy.

To submit a complaint, please complete and return this form. Clearly and legibly type or hand write your complaint. Enclose COPIES of any supporting materials, including any documents or photographs relevant to your complaint. DO NOT INCLUDE ORIGINAL DOCUMENTS. The COPIES you provide will not be returned.

Items and information submitted with your complaint may be disclosed in court proceedings.

This form and all supporting materials must be submitted to this Office by hand-delivery, postal mail, or electronic mail sent to complaintresponse@westchesterda.net.

Notice: Pursuant to the Penal Law, Section 210.45, it is a crime punishable as a class misdemeanor to knowingly make a false statement herein.

First name:

Last name:

Date of Birth:

Street Address:

Municipality:

ZIP Code:

Home phone:Enter 10-digit number, include area code, no dashes or parenthesis

Mobile phone:Enter 10-digit number, include area code, no dashes or parenthesis

E-mail:

Subject Information: (Person(s) or business(es) whom you are making a complaint about)

(1) Subject Name:

Date of Birth:

Street Address:

Municipality:

ZIP Code:

Home phone:Enter 10-digit number, include area code, no dashes or parenthesis

Mobile phone:Enter 10-digit number, include area code, no dashes or parenthesis

E-mail:

(2) Subject Name:

Date of Birth:

Address:

Municipality:

ZIP Code:

Home phone:

Mobile phone:

E-mail:

Have you reported this complaint to any other law enforcement agencies?

Yes

If yes, please indicate which agencies:

Please state your complaint clearly and concisely. Provide a factual summary of events. Be specific. Where appropriate include relevant dates, times and locations as well as the name, address and phone number of any person known to have information or evidence related to your complaint. If necessary, please use additional paper to complete your complaint - sign and date each page.

Notice: Pursuant to the Penal Law, Section 210.45, it is a crime punishable as a Class “A” Misdemeanor to knowingly make a false statement in this complaint or in any document submitted with this complaint.

Enter complaint

Signature

Complaint Form

Your Information

Law Enforcement Agency Information

Westchester County District Attorney

Complaint Form

Your Information

Law Enforcement Agency Information