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.

* Indicates required fields.

Disclosure election Confidentiality and Anonymity is not requested If necessary you may contact me for additional inform I wish to remain Confidential You may contact me for additional information but please keep my name I wish to remain Anonymous Please note if you choose to remain anonymous it is not necessary to fill 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 Application (If your allegations include multiple subjects please provide additional documentation to clarify in part IV)

= 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 your matter.) Have you reported this matter to any other organizations/agencies? (yes or no) If so, who?