United States Army Intelligence and Security Command

INSCOM Inspector General Action Request

This web form may be used to submit a report to the INSCOM IG. Although anonymous submissions are allowed, action cannot be taken on your behalf without sufficient identifying information. This form is not intended for general complaints, and should only be used in circumstances where the attention of the INSCOM IG is required.

Section I: Requester Information
Full Name: 
SSN: 
Grade/Rank: 
Component/Status:
Unit and Complete Military Address: 
Preferred Mailing Address: 
(If different from military address. Include Zip)
Preferred Contact Telephone: 
E-mail Address: 

Section II: Action Request
Specific Action Requested (What do you want the IG to do for you?) (Required)
List the name, duty position and phone number for each individual you have addressed the issue(s) with (Chain of Command, supervisor(s), MER, CPAC/CPOC, Patient representative, IG, Member of Congress, other) and what did they do for you? (Required)
Who else has information relevant to you issue(s) (witnesses names and phone numbers)? (Required)
Does your complaint involve classified information? (Required) 
Do you give permission for the IG to use your name on your behalf? (Required) 
Please describe in detail the issue(s) for which you want IG assistance:
** Disabled when classified.

Section III: Attachments
** Disabled when classified.

Section IV: Confirmation
 (Required) to the INSCOM IG Privacy Policy.
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 Army. Those who knowingly and intentionally provide false statements on this form are subject to potential punitive and administrative action (UCMJ Art 107, 18 USC 1001).
     

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Site Last Updated: 13APR2016