Submit Complaint Form

Part I - Your Information

You must provide our office with your disclosure election. Your selection of one of the three filing options below implies you have reviewed the provided information and understand the choice you are making. If you have any questions concerning this, you may phone the DISA OIG Hotline at (301) 225-6250 (DSN 375-6250).

Please keep in mind that your decision to elect anonymity may limit our ability to conduct an inquiry, if one is warranted, or to appropriately address your issue. In the event our office needs to contact you for additional information or clarification, please provide an e-mail or physical address and/or telephone number where you feel comfortable in accepting our contact. Your complaint cannot be processed without your election below.

Disclosure election option descriptions.

• Confidentiality and anonymity is not requested. If necessary you may contact me for additional information. I do not place any restrictions on the release of my contact information.

• I wish to remain confidential. You may contact me for additional information but please keep my name confidential and do not share it outside of the Office of the Inspector General. Please note: the DISA OIG can never fully guarantee confidentiality because the nature of the complaint or certain legal situations (such as a subpoena) may require us to reveal your name in order to resolve the matter presented. If we must release your identity, we will first attempt to notify you and to obtain a Privacy Act Information Release Statement.

• I wish to remain anonymous. Please note if you choose to remain anonymous it is not necessary to fill out the contact information. It is important to note, however, that we will not be able to contact you regarding your complaint, and in some instances, this may cause us to dismiss the complaint for lack of sufficient information.

Please make your selection below.

Disclosure election Confidentiality and anonymity is not requested I wish to remain confidential I wish to remain anonymous First Name Last Name Job Title/Series/Grade DISA Component Office Mailing Address City and State Zip/Postal Code Email Address Preferred Telephone

Part II - Allegation Details

Subject's First Name Subject's Last Name Subject's Rank/Title/Grade DISA Component Office Additional subjects if applicable. (If your allegations include multiple subjects please provide additional documentation to clarify in part III)

Part III - Incident Details

What did the person(s) do or fail to do that was wrong? When did the incident(s) occur? When were you made aware of the problem(s)? Where did the incident(s) take place? What rule, regulation or law do you believe to have been violated? What would you like DISA OIG to do? (Briefly summarize how you believe our office can assist you regarding this matter.) Have you reported this matter to any other organizations/agencies? (yes or no) If so, who?