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THIS IS AN UNCLASSIFIED FORM.

PLEASE DO NOT INSERT ANY


CLASSIFIED INFORMATION IN THIS FORM.

OFFICE OF THE INSPECTOR GENERAL OF THE INTELLIGENCE COMMUNITY


REPORT OF FRAUD, WASTE, OR ABUSE

NOTE: This is not the process for submitting classified complaints/information. DO NOT SEND CLASSIFIED INFORMATION
IN THIS FORM. Call the ICIG Hotline (1-855-731-3260) for further guidance.

Is your complaint classified?


□ Yes (if YES, call 1-855-731-3260 for guidance)
□ No (if NO, proceed with the form)

The Office of the Intelligence Community Inspector General (ICIG) will not disclose your identity without your consent, unless the
Inspector General (IG) determines that such a disclosure is unavoidable during the course of an investigation or the disclosure is made to
an official of the Department of Justice responsible for determining whether a prosecution should be undertaken.
□ I understand the ICIG will protect my identity to the maximum extent possible by law.

Enter your complaint or information about the specific matter you are reporting in the form below. After entering your
information, save the form, and email the completed form to icighotline@dni.gov.

You can report anonymously; however, please provide sufficient details, i.e., names, dates, organizations, contract numbers,
etc., to facilitate a thorough review and referral of your complaint or issue by our Hotline officers.

NAME (LEAVE BLANK IF REMAINING ANONYMOUS) E-MAIL ADDRESS (LEAVE BLANK IF REMAINING PHONE NUMBER (LEAVE BLANK IF REMAINING ANONYMOUS)
ANONYMOUS)

Agency/Grade/Title/Government or Contractor:

TOPIC OF CONCERN/COMPLAINT

WHO WAS INVOLVED? WHAT IS THEIR AGENCY AFFILIATION (GOV’T/CONTRACTOR)?

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WHERE DID THE INCIDENT OCCUR?

WHEN DID THIS INCIDENT OCCUR?

WAS THIS PREVIOUSLY REPORTED? IF SO, TO WHOM? DO YOU KNOW OF ANY ACTION TAKEN?

WHO NEEDS TO BE INFORMED ABOUT THE INCIDENT?

HOW ARE YOU HOPING THE IC IG CAN ASSIST?

DO YOU HAVE ANY DOCUMENTS RELATED TO THIS MATTER?

SPECIFIC DETAILS OF CONCERN/COMPLAINT

THIS IS AN UNCLASSIFIED FORM. PLEASE DO NOT INSERT ANY


CLASSIFIED INFORMATION IN THIS FORM.
THIS IS AN UNCLASSIFIED FORM. PLEASE DO NOT INSERT ANY
CLASSIFIED INFORMATION IN THIS FORM.

SPECIFIC DETAILS OF CONCERN/COMPLAINT (continued):

Providing your identity to the ICIG allows investigators to contact you for further details concerning your allegation. At times,
ICIG investigators may need to contact investigators or officials, within another component or agency, while conducting an
investigation. Do you consent to the disclosure of your identity, through official channels outside the ICIG, if it becomes necessary
to take further action on this matter?

□ I consent to the disclosure of my identity, through official channels outside the ICIG, if it becomes necessary to take further action
on this matter. I understand that I must contact the ICIG, in writing, if I decide to withdraw my consent at a later date.

□ I do not consent to the disclosure of my identity, but understand my identity may be disclosed through official channels outside the
ICIG, if the IG determines that disclosure is unavoidable during the course of an investigation.

□ I wish to remain anonymous and understood my anonymity may limit the ICIG’s ability to investigate my allegation.

THIS IS AN UNCLASSIFIED FORM. PLEASE DO NOT INSERT ANY


CLASSIFIED INFORMATION IN THIS FORM.