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Complaint Form


WARNING

If you are using the online complaint form, we cannot guarantee your privacy because your online complaint has not been encrypted for transmission to us. By using the form below to submit your complaint via the Internet, you acknowledge that your privacy is not guaranteed and that you are doing so at your own risk. If you are not comfortable submitting your complaint via the Internet, we recommend that you contact us by telephone at (202) 712-1023 or toll free at 1-800-230-6539. Alternatively, you may print out the complaint form (PDF) and submit it via fax to (202) 216-3801 or mail it to U.S. Agency for International Development, Office of Inspector General, P.O. Box 657, Washington, DC 20044-0657, or you can send an email to the hotline email address at ig.hotline@usaid.gov.


Information about you:

I wish to:

     Remain anonymous.

     Provide information confidentially to Office of Inspector General (OIG) personnel.

     Waive confidentiality and agree to be contacted by OIG personnel and others outside OIG.

If you agree to waive confidentiality and to be contacted by OIG personnel and others, please provide your contact information as listed below:

Name:    

E-mail Address:     

Mailing Address1:  

Mailing Address2:  

City/State/Zip:  

Country:    

Telephone:  

Fax:     


If your concerns involve USAID funding requests, human resources/employment issues, or education requests, please forward them to pinquiries@usaid.gov.


The alleged violator (enter all available information):

Name or Business Name:    

Business Title:  

Business/Agency Name:    

Address1:  

Address2:  

City/State/Zip:    

Country:    

Telephone:  

Fax:    



What would you like to report?    The selection of one or more allegation types is required.

  False Claims   Bribery/Conflict of Interest
  Theft/Embezzlement   Employee Misconduct
  Mismanagement   Contract, Grant, or Procurement Fraud
  Computer Crime   Travel/Time and Attendance Fraud
  Credit Card Fraud   False Statements
Other - Please explain

To help us evaluate your complaint, please provide responses to the following questions:

  1.  What is the problem you want to report?   Describe the problem as specifically as possible.


  2.  When and how did you become aware of the problem?


  3.  How long has the problem existed?


  4.  When was the most recent occurrence of this problem?


  5.  Can you identify any documents, persons, or activities that we can use to verify the problem?

  6.  Is there any additional information that might be useful to us in evaluating this complaint?




  Contact Requested: Please contact me as soon as possible regarding this matter.


               

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Mon, 09 Jun 2008 15:58:14 -0500
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