Some fields have been left blank. You must fill out all fields marked with a red asterisk before submitting.
Complainant:
DHS Employee?
Your Filing Category
Your Employer
Your Filing Category
Alleged Offender(s):
Person, Agency or Business?
Unknown or Known Identity?
2: Person, Agency, or Business?
2: Unknown or Known Identity?
3: Person, Agency, or Business?
3: Unknown or Known Identity?
4: Person, Agency, or Business?
4: Unknown or Known Identity?
5: Person, Agency, or Business?
5: Unknown or Known Identity?
6: Person, Agency, or Business?
6: Unknown or Known Identity?
7: Person, Agency, or Business?
7: Unknown or Known Identity?
8: Person, Agency, or Business?
8: Unknown or Known Identity?
9: Person, Agency, or Business?
9: Unknown or Known Identity?
10: Person, Agency, or Business?
10: Unknown or Known Identity?
Where:
Incident Locations
What:
Allegation Category
Allegation
How:
Summary of Incident
Submit:
Name of complainant has not been entered; if complainant wishes to remain anonymous you must check the acknowledgment box affirming your understanding the OIG will not be able to send you a Complaint Number Notification email alert message
Name of complainant has been entered and complainant has selected option to remain anonymous. To complete form submission; either remove name in order to submit anonymously, or remove acknowledgement of anonymous filing by un-checking this option in the submit portion of this form.
You must agree to all terms and conditions cited
Some Fields are not in the proper format.
Complainant:
Primary Phone - Must have 10 Digits if in United States
Secondary Phone - Must have 10 Digits if in United States
Email Address
ZIP Code
Alleged Offender(s):
Primary Phone - Must have 10 Digits if in United States
Secondary Phone - Must have 10 Digits if in United States
Email Address
ZIP Code
2: Primary Phone - Must have 10 Digits if in United States
2: Secondary Phone - Must have 10 Digits if in United States
2: Email Address
2: ZIP Code
3: Primary Phone - Must have 10 Digits if in United States
3: Secondary Phone - Must have 10 Digits if in United States
3: Email Address
3: ZIP Code
4: Primary Phone - Must have 10 Digits if in United States
4: Secondary Phone - Must have 10 Digits if in United States
4: Email Address
4: ZIP Code
5: Primary Phone - Must have 10 Digits if in United States
5: Secondary Phone - Must have 10 Digits if in United States
5: Email Address
5: ZIP Code
6: Primary Phone - Must have 10 Digits if in United States
6: Secondary Phone - Must have 10 Digits if in United States
6: Email Address
6: ZIP Code
7: Primary Phone - Must have 10 Digits if in United States
7: Secondary Phone - Must have 10 Digits if in United States
7: Email Address
7: ZIP Code
8: Primary Phone - Must have 10 Digits if in United States
8: Secondary Phone - Must have 10 Digits if in United States
8: Email Address
8: ZIP Code
9: Primary Phone - Must have 10 Digits if in United States
9: Secondary Phone - Must have 10 Digits if in United States
9: Email Address
9: ZIP Code
10: Primary Phone - Must have 10 Digits if in United States
10: Secondary Phone - Must have 10 Digits if in United States
10: Email Address
10: ZIP Code
When:
Format: mm/dd/yyyy
Cannot be beyond current date
Cannot be before DHS was established

INDIVIDUALS INVOLVED

Complainant:

First Name:
MI:
Last Name:
Address Type:
Work
Home
Address:
City:
ZIP:
State/Territory:
Country/Region:
Primary Phone:
Secondary Phone:
Email:
Is the Complainant a
DHS Employee?
Yes No
Select employee affiliation to view remaining fields in this section.

Alleged Offender(s):

Select an option most appropriate for the Offender:
Person
DHS Agency or Bureau
Corporation / Business
Select offender type to view additional fields in this section.
DHS Agency or Bureau:
Corporation or Business Name:
The Person is:
Fully Identified
Partially Identified
Unidentified
Gender:
Male
Female
First Name:
MI:
Last Name:
Alias:
Nickname:
Alleged Offender's Employment Category:
Alleged Offender's Employer:
Miscellaneous Identifiers (e.g. job title, tattoos, etc.)
Height:
ft/in
Weight:
lbs
Hair:
Eyes:
Race:
Address Type:
Work
Home
Address:
City:
ZIP:
State / Territory:
Country / Region:
Primary Phone:
Secondary Phone:
Email:

Alleged Offender :

Select an option most appropriate for the Offender:
Person
DHS Agency or Bureau
Corporation / Business
Select offender type to view additional fields in this section.
DHS Agency or Bureau:
Corporation or Business Name:
The Person is:
Fully Identified
Partially Identified
Unidentified
Gender:
Male
Female
First Name:
MI:
Last Name:
Alias:
Nickname:
Alleged Offender's Employment Category:
Alleged Offender's Employer:
Miscellaneous Identifiers (e.g. job title, tattoos, etc.)
Height:
ft/in
Weight:
lbs
Hair:
Eyes:
Race:
Address Type:
Work
Home
Address:
City:
ZIP:
State / Territory:
Country / Region:
Primary Phone:
Secondary Phone:
Email:

Alleged Offender :

Select an option most appropriate for the Offender:
Person
DHS Agency or Bureau
Corporation / Business
Select offender type to view additional fields in this section.
DHS Agency or Bureau:
Corporation or Business Name:
The Person is:
Fully Identified
Partially Identified
Unidentified
Gender:
Male
Female
First Name:
MI:
Last Name:
Alias:
Nickname:
Alleged Offender's Employment Category:
Alleged Offender's Employer:
Miscellaneous Identifiers (e.g. job title, tattoos, etc.)
Height:
ft/in
Weight:
lbs
Hair:
Eyes:
Race:
Address Type:
Work
Home
Address:
City:
ZIP:
State / Territory:
Country / Region:
Primary Phone:
Secondary Phone:
Email:

Alleged Offender :

Select an option most appropriate for the Offender:
Person
DHS Agency or Bureau
Corporation / Business
Select offender type to view additional fields in this section.
DHS Agency or Bureau:
Corporation or Business Name:
The Person is:
Fully Identified
Partially Identified
Unidentified
Gender:
Male
Female
First Name:
MI:
Last Name:
Alias:
Nickname:
Alleged Offender's Employment Category:
Alleged Offender's Employer:
Miscellaneous Identifiers (e.g. job title, tattoos, etc.)
Height:
ft/in
Weight:
lbs
Hair:
Eyes:
Race:
Address Type:
Work
Home
Address:
City:
ZIP:
State / Territory:
Country / Region:
Primary Phone:
Secondary Phone:
Email:

Alleged Offender :

Select an option most appropriate for the Offender:
Person
DHS Agency or Bureau
Corporation / Business
Select offender type to view additional fields in this section.
DHS Agency or Bureau:
Corporation or Business Name:
The Person is:
Fully Identified
Partially Identified
Unidentified
Gender:
Male
Female
First Name:
MI:
Last Name:
Alias:
Nickname:
Alleged Offender's Employment Category:
Alleged Offender's Employer:
Miscellaneous Identifiers (e.g. job title, tattoos, etc.)
Height:
ft/in
Weight:
lbs
Hair:
Eyes:
Race:
Address Type:
Work
Home
Address:
City:
ZIP:
State / Territory:
Country / Region:
Primary Phone:
Secondary Phone:
Email:

Alleged Offender :

Select an option most appropriate for the Offender:
Person
DHS Agency or Bureau
Corporation / Business
Select offender type to view additional fields in this section.
DHS Agency or Bureau:
Corporation or Business Name:
The Person is:
Fully Identified
Partially Identified
Unidentified
Gender:
Male
Female
First Name:
MI:
Last Name:
Alias:
Nickname:
Alleged Offender's Employment Category:
Alleged Offender's Employer:
Miscellaneous Identifiers (e.g. job title, tattoos, etc.)
Height:
ft/in
Weight:
lbs
Hair:
Eyes:
Race:
Address Type:
Work
Home
Address:
City:
ZIP:
State / Territory:
Country / Region:
Primary Phone:
Secondary Phone:
Email:

Alleged Offender :

Select an option most appropriate for the Offender:
Person
DHS Agency or Bureau
Corporation / Business
Select offender type to view additional fields in this section.
DHS Agency or Bureau:
Corporation or Business Name:
The Person is:
Fully Identified
Partially Identified
Unidentified
Gender:
Male
Female
First Name:
MI:
Last Name:
Alias:
Nickname:
Alleged Offender's Employment Category:
Alleged Offender's Employer:
Miscellaneous Identifiers (e.g. job title, tattoos, etc.)
Height:
ft/in
Weight:
lbs
Hair:
Eyes:
Race:
Address Type:
Work
Home
Address:
City:
ZIP:
State / Territory:
Country / Region:
Primary Phone:
Secondary Phone:
Email:

Alleged Offender :

Select an option most appropriate for the Offender:
Person
DHS Agency or Bureau
Corporation / Business
Select offender type to view additional fields in this section.
DHS Agency or Bureau:
Corporation or Business Name:
The Person is:
Fully Identified
Partially Identified
Unidentified
Gender:
Male
Female
First Name:
MI:
Last Name:
Alias:
Nickname:
Alleged Offender's Employment Category:
Alleged Offender's Employer:
Miscellaneous Identifiers (e.g. job title, tattoos, etc.)
Height:
ft/in
Weight:
lbs
Hair:
Eyes:
Race:
Address Type:
Work
Home
Address:
City:
ZIP:
State / Territory:
Country / Region:
Primary Phone:
Secondary Phone:
Email:

Alleged Offender :

Select an option most appropriate for the Offender:
Person
DHS Agency or Bureau
Corporation / Business
Select offender type to view additional fields in this section.
DHS Agency or Bureau:
Corporation or Business Name:
The Person is:
Fully Identified
Partially Identified
Unidentified
Gender:
Male
Female
First Name:
MI:
Last Name:
Alias:
Nickname:
Alleged Offender's Employment Category:
Alleged Offender's Employer:
Miscellaneous Identifiers (e.g. job title, tattoos, etc.)
Height:
ft/in
Weight:
lbs
Hair:
Eyes:
Race:
Address Type:
Work
Home
Address:
City:
ZIP:
State / Territory:
Country / Region:
Primary Phone:
Secondary Phone:
Email:

Alleged Offender :

Select an option most appropriate for the Offender:
Person
DHS Agency or Bureau
Corporation / Business
Select offender type to view additional fields in this section.
DHS Agency or Bureau:
Corporation or Business Name:
The Person is:
Fully Identified
Partially Identified
Unidentified
Gender:
Male
Female
First Name:
MI:
Last Name:
Alias:
Nickname:
Alleged Offender's Employment Category:
Alleged Offender's Employer:
Miscellaneous Identifiers (e.g. job title, tattoos, etc.)
Height:
ft/in
Weight:
lbs
Hair:
Eyes:
Race:
Address Type:
Work
Home
Address:
City:
ZIP:
State / Territory:
Country / Region:
Primary Phone:
Secondary Phone:
Email:

WHEN? (if Known)

Date Incident Occurred: (mm/dd/yyyy)
Alleged Offender was:
On Duty / Duty Related Off Duty

WHERE?

You have reached the maximum number of characters, your text has been shortened to fit this form.
Incident Location(s):
(Limit to 500 characters)

WHAT?

Affected DHS Agency or Bureau (If Known)

Identify the category or categories (if applicable) of allegation(s) the alleged offender(s) have engaged in

Allegation Category:
Allegation:
Allegation Detail:

HOW?

Summary of Allegation (to include: how you know this incident occurred, supporting evidence you may have, names and contact information of other witnesses / victims, etc.) (limit to 4,000 characters)

You have reached the maximum number of characters, your text has been shortened to fit this form.

DHS OIG accepts or refers complaint allegations based, in part, upon agency responsibilities. If we determine that your allegation should be investigated by another agency, we may refer it to that agency for any action it deems necessary.

By submitting this form, you certify that all of the statements made in this allegation (including Continuation pages and addenda) are true, complete, and correct to the best of your knowledge and you understand that a deliberate false statement, or deliberate concealment of a material fact, is a criminal offense (Title 18 U.S.C. Section 1001) for which you may be prosecuted.

I authorize the DHS OIG to release my contact information, as submitted above, to the appropriate investigating entities as deemed necessary.

I wish to remain anonymous and not provide a point of contact email and thus waive any expectation that the DHS OIG will be able to send me a Complaint Number confirmation notification.

Complainant filed as "anonymous" and waived his/her receipt of a DHS OIG Complaint Number notification email message.

I agree to all terms and conditions as previously cited.