Rochester, PA · Beaver County
Complaint Form
Rochester residents or others making a complaint can use this form to provide their contact information, incident details, witness information, and desired outcome.
What this form is
The Complaint Form collects the name and contact details of the person making a complaint, along with the incident date, time, location, subject, and a summary of the issue. It also provides space for witness details and asks whether the person wants a particular outcome. The document does not state when filing is required.
Who needs it
A person making a complaint can use this form to provide incident details, optional witness information, and any outcome they would like.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This complaint form has no notary block; it requests complaint and witness details, and identifies no notarized attachment or sworn step.
How to submit this form
- 1
Download The Form
Download the Complaint Form PDF.
- 2
Complete The Complaint Details
Provide your contact information and the incident date, time, location, subject, and complaint summary.
- 3
Add Witness And Outcome Details
If applicable, provide witness details and indicate whether you would like an outcome; the form lists no attachments.
- 4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What information does the Complaint Form ask for?
- It asks for the complainant’s name and contact details, incident date, time and location, the subject and summary of the complaint, optional witness details, and any desired outcome.
- Who can use Rochester’s Complaint Form?
- A person making a complaint can use the form to share their contact information and details about the incident, with witness information and a desired outcome if applicable.
- Do I need a notary for the Complaint Form?
- No. The form has no notary block and identifies no notarized attachment or sworn step.
- How do I submit the Complaint Form?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Complaint Form doesn’t need a notary — but if you have another Rochester form that does, a commissioned online notary can help.