Federal Action Reporting Form

First Name Tell us your FIRST Name

Last Name

Phone Number

Email

If you have an attorney or representative, please provide their name and contact information

Were you physically present during the incident? Tell us if you were present during this incident.

YES

NO

Where did this happen? Tell us where this happened.

Date

Estimated Time Tell us the estimated time this happened.

:

Describe the incident and include any other relevant information. Please provide as much detail as possible. Describe the Incident.

Video Link 1 Link to the video.

Description Description for Video Link 1

Did you take this video?

YES

NO

In providing the information I have entered on this form, I understand and agree that:

The information I am providing may be used by the Minnesota Attorney General’s Office (“AGO”) to: (1) Attempt to resolve the issue about which I am contacting the Office, (2) Communicate with me, and (3) Assist in enforcing the law, including as evidence in court.
I understand that the information I provide will be accessible to: (1) AGO staff and agents whose work assignments reasonably require access, (2) Other entities authorized by state or federal law, (3) Persons authorized pursuant to a court order, and (4) To others subject to my informed consent.
For the purposes described above, I consent to the AGO disseminating information I provide to other law enforcement agencies and/or the party complained against. I understand that under certain circumstances, the AGO is permitted to make data gathered in an investigation public without my consent, including by using it in court filings.
I understand that I am not legally required to provide the information I have submitted or to consent to its release, but my failure to do so may make it more difficult to resolve my concerns.
I understand that the AGO does not control the use or dissemination of information provided to third parties pursuant to my consent.
I understand that the information I am providing is subject to the Minnesota Government Data Practices Act, Minn. Stat. ch. 13, and shall not be used or disseminated except as authorized by this consent or applicable state or federal law.

By choosing Accept below, I consent to and acknowledge the statements outlined above.

Accept

Tuesday, February 24, 2026