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Report a Complaint

This form may be used to present an allegation that a cleric (bishop, priest, deacon) has committed an act of sexual abuse of a minor. The completed form is CONFIDENTIAL and is to be submitted via e-mail.

To report a complaint of sexual abuse by a member of the clergy or anyone acting in the name of the Church, recently or in the past, please complete the form below and return it to the Archdiocese of New York. You may print the form and mail it to the Archdiocese, or you may send the form via email.

Online Form: Submit Complaint Online

After you submit the completed form, the Victim's Assistance Coordinator for the Archdiocese of New York will contact you.


(* Required)  
I. INFORMATION AS TO THE COMPLAINANT
Full Name
Address
City, State, Zip
Date of Birth
Name and Address of Parents/Guardian
(if complainant is a minor)
Phone
Name of School(if complainant is a minor)
II. INFORMATION AS TO ACCUSED
Name
Parish/Place of employment
Has the accused been confronted or informed of allegation? * No
  Yes
If Yes, when and by whom?
III. INFORMATION AS TO ALLEGATIONS
Brief description of alleged abuse
(time, place, and acts):
Have the allegations been reported to any civil authorities or Church personnel? * No
  Yes
If yes, when, how, and to whom?
Date of Report
PERSON REPORTING
Name
City, State Zip
Phone
E-mail
 

* All contact information submitted will be handled with the utmost discretion.

  

Other Methods to Submit a Complaint

U.S. Postal Service: Submit Complaint via U.S. Mail

If you select to mail your form via the US Postal Service please select one of the following printable versions:

Report A Complaint Form (MS Word)

Report A Complaint Form (Adobe PDF)

 

E-Mail: Submit Complaint via E-Mail

If you would like to send your complaint as an attachment utilizing your e-mail service, please use the following Word form document.

Report a Complaint Form Via E-mail (MS Word)

Report a Complaint Form (in Spanish)