Department of the Air Force Inspector General

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DATA REQUIRED BY THE PRIVACY ACT OF 1974

AUTHORITY: 10 U.S.C. 9013 Secretary of the Air Force, 10 U.S.C. 9020 Inspector General, 44 U.S.C. 3101 Records Management, Air Force Instruction 90-301, Inspector General Complaints Resolution and EO 9397.

PRINCIPAL PURPOSE(S): To register a personal complaint relating to individual injustices or suspected Fraud, Waste, and/or Abuse.

ROUTINE USE(S): Data provided are furnished to supervisors, commanders or inspectors in response to queries for resolution of
complaints and to eliminate conditions considered detrimental to the efficiency or reputation of the Air Force.

DISCLOSURE: Voluntary; However, failure to provide the information will not adversely affect the resolution of your complaint but may
delay the IG or investigating officer in resolving the issue.

SORN: F090 AF IG B, Inspector General Records (May 29, 2012, 77 FR 31591)

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Required fields are marked with *

DO YOU WISH TO REMAIN ANONYMOUS?

Note: If you file anonymously, we will be unable to contact you to obtain more information about the case or provide you the results if we conduct an investigation. If you choose to remain anonymous, do not identify yourself below.

Name

Rank/Title

First

Middle

Last

DOD ID (Leave blank if you do not have a DOD ID)

PREFERRED CONTACT TELEPHONE (duty, home, and /or cell)

E-MAIL ADDRESS

Confirm

Do you belong to any of these Air Force/Space Force organizations?

UNIT AND COMPLETE MILITARY ADDRESS (if applicable)

Unit

Street

City

State/Region

Country

Zip

PREFERRED MAILING ADDRESS (If different from military address, including ZIP Code)

Street

City

State/Region

Country

Zip

COMPONENT / DUTY STATUS

GRADE/RANK

I do / I do not consent to release my 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 below.

I understand that if I do not release my personal information, my request for assistance may go unresolved.

I do / I do not consent to release the supporting documents I provided to the IG (to exclude this DAF Form) outside of IG channels to the chain command or other officials (but within DoD channels) in order to resolve the matters listed below.

I understand that if I do not release my documents, my request for assistance may go unresolved.

ARE YOU WILLING TO BE INTERVIEWED?

What can the IG do for you?

Who do you believe did something wrong or wronged you? {Subject(s)/Suspect(s)}

(Please fill out the information below as completely as possible)

Name (Subject 1)

Rank/Title

First

Middle

Last

DOD ID

Phone:

Unit/Address

Unit

Street

City

State/Region

Country

Zip

COMPONENT / DUTY STATUS

GRADE/RANK

Please list the rank, name, unit and contact information of any other subjects

What did the subject do, or fail to do, that was wrong?

What rule, regulation, or law do you believe the subject(s) violated?

Have you sent your complaint to a Member of Congress?

If YES, enter the name(s) of the Member(s) of Congress and the date you contacted them below.

Name(s) of Congressperson(s) and date(s) you contacted them

When did the incident occur? Provide dates and times, if possible.

Where did the incident take place? What location, command, etc.?

Why do you think the incident took place?

How have you tried to resolve the problem?

Who else do you believe has information regarding this request? Add contact information if possible.

This information is submitted for the basic purpose of requesting assistance, correcting injustices affecting the individual, or eliminating conditions considered detrimental to the efficiency or reputation of the Air Force. Those who knowingly and intentionally provide false statements on this form are subject to potential punitive and administrative action (UCMJ Art 107, 18 U.S.C. 1001).

SIGNATURE (Limit 35 characters)

DATE

Click the "Submit Inspector General Action Request" button below to certify and submit the form.

Complaints are transferred to the appropriate level IG. We encourage you to contact your local IG directly.

Email:
- Download the DAF Form 102 here -- DAF102 Inspector General Complaint Form
- Save form to desktop
- Complete and save form
- Email completed form to: [email protected]

US MAIL:
- Download the DAF Form 102 here -- DAF102 Inspector General Complaint Form
- Save form to desktop
- Complete and save form
- Print form and mail to:

Office of the AF Inspector General
Attention: Complaints Resolution Directorate
1140 AF Pentagon
Washington DC 20330-1140

NOTE: Any records or documents provided to the IG become part of an IG record and are not returnable unless a FOIA request is submitted (see Chapter 10 and AFI 33-332, Air Force Privacy and Civil Liberties Program). In addition, DO NOT mail CDs, DVDs, or thumb drives.

IG Hotline:
- Call 1-800-538-8429
-- Select option 6
--- Once prompted to leave a message, leave a detailed message along with contact information

Information on Filing Hotline Complaints

Do not enter any classified information on this form

Do not enter any classified information on this form

Required fields are marked with *