Office of the Inspector General - Complaint Form

DATA REQUIRED BY THE PRIVACY ACT OF 1974
AUTHORITY:Title 10, USC, Section 3020.
PRINCIPAL PURPOSE:To secure sufficient information to make inquiry into the matters presented and to provide a response to the requestor(s) and/or take action to correct deficiencies.
ROUTINE USES:Information is used for official purposes within the Department of Defense; to answer complaints or respond to requests for assistance, advice or information; by Members of Congress and other Government agencies when determined by The Inspector General to be in the best interest of the Army; and in certain cases, in trial by courts- martial other military matters as authorized by the Uniform Code of Military Justice. Department of Defense Blanket Routine Uses also apply.
DISCLOSURE OF THE SOCIAL SECURITY NUMBER AND OTHER PERSONAL INFORMATION IS VOLUNTARY. HOWEVER, FAILURE TO PROVIDE COMPLETE INFORMATION MAY HINDER PROPER IDENTIFICATION OF THE REQUESTOR, ACCOMPLISHMENT OF THE REQUESTED ACTION(S) AND RESPONSE TO THE REQUESTOR.

Your information (Optional) - leave fields blank or unchecked for anonymous input


First Name
Last Name
Middle Name or Initial
Rank
Phone
Email
Home Address
Unit Address
Component
I wish to remain anonymous
I am willing to be interviewed
I have supporting documentation
I consent to the release of information below

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Who else do you believe has information regarding your complaint (Optional)?



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