Office of the Inspector General
Complaint Form

DATA REQUIRED BY THE PRIVACY ACT OF 1974
AUTHORITY: 10 U.S.C 3013, Secretary of the Army; 10 U.S.C 3020, Inspector General Act of 1978 (Public Law, 95-452), as amended; DoDD 1030.1, Victim and Witness Assistance; AR 20-1, Inspector General Activities and Procedures.
PRINCIPAL PURPOSE: To secure sufficient information to inquire into the matters presented and to provide a response to the requester(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 and other Military matters as authorized by the Uniform Code of Military Justice.
DISCLOSURE: Voluntary, however, failure to provide complete information may hinder proper identification of the requester, accomplishment of the requested action(s), and response to the requester.
SORN: A0020-1 SAIG, Inspector General Records (January 11, 2002, 67 FR 1447)
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.


Complaint Form
Complainant/Initiator
Last Name: First Name: MI:
Rank/Grade: Phone: Email:
DOD ID: Home Address:
Unit Address: Component:
Do you wish to remain anonymous?
Are you willing to be interviewed?
What can the IG do for you? Please state what you need help with. Please provide specific details regarding the issue/allegation.
Who else do you believe has information regarding your complaint (name, phone number, email, etc)?
Do you consent to release your personal information outside of IG channels to the chain of command or other officials (but within DoD channels) in order to resolve the matters listed above. I understand that if I do not release my personal information, my request for assistance may go unresolved?
Do you have supporting documentation?
Do you consent to release the supporting documents you provided to the IG (to exclude this DA Form) outside of IG channels to the chain command or other officials (but within DoD channels) in order to resolve the matters listed above. I understand that if I do not release my documents, my request for assistance may go unresolved?

Maximum Files: 100 
   
If you need to speak to someone immediately contact the SDDC IG at 1-800-863-9502 or 618-220-5033. SDDC email: usarmy.scott.sddc.mbx.ig-hotline@army.mil