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Part I - Complainant Information

Your selection of one of the filing options below implies you have reviewed the information and understand the choice you are making. 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 consider providing your name and/or contact information to allow for follow-up contact if needed. Your complaint cannot be processed without your election below.

(*) Required Information

  I am submitting the complaint myself.
  I am submitting the complaint on behalf of someone else.
  I am submitting this complaint as a DHS internal affairs agency.

Complainant

Prefix (Mr.,Mrs.,Ms.,etc.)

First name

Last name

Suffix (Jr., Sr., II., etc.)

Address Type: Home Work

Address:

City:

State/Territory:

Zip:

Country/Region:

* Either Phone or E-mail is required

Primary Phone:

Email:

Is the complainant a current DHS employee, former DHS employee, or DHS contractor? *

Yes No

Part II - Allegation Details

Use this section to clearly describe your complaint. If you would like additional information about filing a reprisal complaint, please click here.
IDENTIFY THE SUBJECT(s) - WHO COMMITTED THE ALLEGED WRONGDOING?

(*) Required Information

Please click the Save button to save or update the data. If you want to add another Witness, please click the Add Witness button.

Prefix (Mr.,Mrs.,Ms.,etc.)

First name

Last name

Suffix (Jr., Sr., II., etc.)

Address Type: Work Home

Address:

City:

State/Territory:

Zip:

Country/Region:

Primary Phone:

Email Address:

Is the Witness a current DHS employee, former DHS employee, or DHS contractor?*

Yes No

Please click the Save button to save or update the data. If you want to add another Witness, please click the Add Witness button.

Prefix (Mr.,Mrs.,Ms.,etc.)

First name

Last name

Suffix (Jr., Sr., II., etc.)

Address Type: Work Home

Address:

City:

State/Territory:

Zip:

Country/Region:

Primary Phone:

Email Address:

Is the Witness a current DHS employee, former DHS employee, or DHS contractor?*

Yes No

Please click the Save button to save or update the data. If you want to add another Victim, please click the Add Victim button.

Prefix (Mr.,Mrs.,Ms.,etc.)

First name

Last name

Suffix (Jr., Sr., II., etc.)

Address Type: Work Home

Address:

City:

State/Territory:

Zip:

Country/Region:

Primary Phone:

Email Address:

Is the Victim a current DHS employee, former DHS employee, or DHS contractor?*

Yes No

Please click the Save button to save or update the data. If you want to add another Victim, please click the Add Victim button.

Prefix (Mr.,Mrs.,Ms.,etc.)

First name

Last name

Suffix (Jr., Sr., II., etc.)

Address Type: Work Home

Address:

City:

State/Territory:

Zip:

Country/Region:

Primary Phone:

Email Address:

Is the Victim a current DHS employee, former DHS employee, or DHS contractor?*

Yes No

IDENTIFY ANY ADDITIONAL INDIVIDUALS RELEVANT TO THE COMPLAINT

Part III - Additional Details

(*) Required Information

We can best process your complaint if we receive accurate and complete information. Provide a summary of your complaint, to include an event chronology, if appropriate.

If your complaint involves contractor fraud, provide the name of the primary contractor, subcontractor, type of contract, contract #s, date of contract award, and name(s) of agency official(s) if known.

Allegation Category

DHS Affected Agency

What did the person(s) do
or fail to do that was wrong?*

When did the incident(s) occur?*

Where did the incident(s) take place(City/State)?*

When were you made aware of the problem(s)?

What rule, regulation, or law do you believe to have been violated?

Briefly summarize how you believe our office can assist you regarding your matter.

Part IV - Other Actions

Please indicate in this section if you have filed your complaint with any other office, to include other Inspector General offices, and your Congressperson. If you have contacted other entities, clearly identify the agency, office, or command, and provide your understanding of the current status of your matter. If you have received any responses from those office(s), provide our office with a copy.

(*) Required Information

Have you reported this matter to any other organizations/agencies? *

Yes No

Part V – Upload Documents

If you have supporting documentation that you wish to provide with this complaint form, please use the 'Add File' button below. Do not send classified documents using this unclassified internet system. We recommend that you scan your documents together into one electronic file, not to exceed 30 MBs total.

PDF files only
You may upload up to 5 files and not to exceed 30 MBs total.

Browse for files

Add File

Part VI - Certifications

(*) Required Information

* I certify that all of the statements made in this complaint are true, complete, and correct, to the best of my knowledge. I understand that a false statement or concealment of a material fact is a criminal offense (18 U.S.C. ~ 1001; Inspector General Act of 1978, As Amended, §7).

* I have provided my election concerning my filing status in Part 1 of this form (Release of Identity, Non-Release of Identity, or Anonymous). I understand that if I have elected anonymous status, it may impact the ability of the DHS OIG to either conduct an inquiry, if warranted, and/or to appropriately address my issue(s). I further understand that if I have elected not to release my identity outside of DHS OIG, my complaint will not be disclosed outside DHS OIG for action, unless this action is determined necessary or required by law. My selection not to disclose my identify outside DHS OIG may also prevent further action from being taken on my complaint.

* I further understand that even if I elect confidential status, my identity may be disclosed, if required by applicable legal authority, or if the DHS OIG, determines that such disclosure is otherwise unavoidable.

Complaint or Case Number
Which Organization/Agency?*
When?*
What is the status of that complaint?*

DHS OIG Hotline Complaint Form

Part I - Complainant Information

Part II - Allegation Details

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New Witness

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Part III - Additional Details

Part IV - Other Actions

Part V – Upload Documents

Part VI - Certifications