Your Contact Information

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Your Contact Information

First and Last Name

Email Address

Phone Number

Street Address

City

State

Zip Code

Details of Compliment

Details of Compliment

Date of Incident

Approximate Time of Incident

Location of Incident

Name(s) or General Description of Involved Officer(s)

Describe What Happened

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Would you like someone from the Leesburg Police Department to contact you?

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If you would like to be contacted, please ensure you have provided your email address and/or phone number above.

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