Submitting an Officer's Name

An Officer Data Form is to be submitted to the Memorial Fund for each officer to be considered for inclusion on the National Law Enforcement Officers Memorial. The form must be completed by an official representative of the department for which the officer served and must be signed by the head of the agency. Otherwise, this form will not be processed.

Names are inscribed on the National Law Enforcement Officers Memorial once a year, in the spring immediately prior to National Police Week. An Officer Data Form must be submitted by the December 31 deadline to be considered for inclusion on the Memorial the following year.

We cannot accept emailed forms. Please either fax or mail them to us at the contact information below.

• Law Enforcement Agency Officer Data Form.
  
  
• Not a Law Enforcement Agency Officer Data Form. The Memorial Fund will contact the appropriate department.
  
   Download a free Adobe Acrobat Reader.

Fax the completed form to:

National Law Enforcement Officers Memorial Fund
Research Department
202-737-3405

Or mail to:

National Law Enforcement Officers Memorial Fund
Officer Data Form
901 E Street, NW
Suite 100
Washington, DC 20004-2025

Process and Criteria for Adding Names to the Memorial

For more information about how names are added to the Memorial, click here. Please note that the criteria for including an officer’s name on the National Law Enforcement Officers Memorial are separate and distinct from the line-of-duty death criteria used by other entities or programs, including state and local law enforcement memorials and the Public Safety Officers’ Benefits (PSOB) Program, U.S. Department of Justice. Acceptance for inclusion on the National Law Enforcement Officers Memorial is no way impacts decisions made by the federal government regarding the awarding of PSOB benefits. For more information about PSOB, visit www.psob.gov or call 1-888-744-6513.