U.S. FLEET FORCES
COMMAND OFFICE
OF
THE
INSPECTOR GENERAL
FRAUD, WASTE,
ABUSE,
& MISMANAGEMENT COMPLAINT FORM
AUTHORITY: Inspector General Act of 1978, as amended, SECNAVINST 5430.57 (series), SECNAVINST 5370.5 (series).
PRINCIPAL PURPOSE(S): To register a complaint relating to suspected Fraud, Waste, Abuse and/or Mismanagement.
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 United States Navy.
DISCLOSURE: Disclosure of your identity and any other personal identifying information is voluntary. Failure to provide the information will not adversely affect
the resolution of your complaint but may cause a delay in resolving the issue.
FALSE OFFICIAL STATEMENT WARNING: Use of this form constitutes a request for an official investigation of a person you assert has engaged in wrongful
conduct. It is a crime to knowingly make a false fictitious or fraudulent statement or representation of material fact to induce government action. Knowing
omission of a material fact is also a crime (18 USC 1001 and Art. 107 UCMJ).
We can only accept UNCLASSIFIED complaints via this form. Please call 1-800-533-2397 to submit classified complaints.
SECTION I - YOUR IDENTITY
Anyone may file a complaint, regardless
of who you are, and you are not required to identify
yourself, exc
ept
f
or
al
legations of
repr
isal. In
order
to remain anonymous, do not provide any identifying information below. You may also elect to
remain confidential, or consent to the release of your identity and complaint outside of Navy IG channels.
If you remain anonymous, we will not be able to contact you to request additional information or provide you the status of
your complaint. Remaining anonymous will not in and of itself affect the disposition of your complaint, however, if we are unable to
reach out to you for additional information, we may dismiss your complaint.
We may also determine that your complaint should be referred outside of Navy IG channels, such as the chain of
command (e.g. the Commanding Officer). Unless you are anonymous, we need your consent to provide your identity and
complaint as part of our referral. If you wish to remain confidential and not provide your consent, we will provide a sanitized
summary of your complaint instead of your actual complaint. If you give us your consent we will provide your actual complaint but
redact your identity unless your identity is necessary to take action. If you wish to remain anonymous, we will provide your actual
complaint as part of the referral.
Regardless of your selection, we will make every attempt to safeguard your identity, but we cannot guarantee
confidentiality as we may be required to disclose your identity as part of an investigation, in the course of corrective action, as a
result of a decision of the U.S. Fleet Forces Command (USFF) IG or as required by any applicable law, rule or regulation.
I consent to the release of my identity and complaint outside of Navy IG channels.
I wish to remain confidential.
I wish to remain anonymous (proceed to Section III).
SECTION II - YOUR BIOGRAPHICAL INFORMATION (Skip if Anonymous)
Last Name First Name
MI
Street Address Line 1
Zip Code
City
State
Street Address Line 2
Country
E-mail (Personal)
E-mail (Work)
Home # Mobile # Work #
Your Status
Grade or Rank Organization (i.e. Dept/Division/Code, if applicable)
How are you aware of
the Hotline Program?
Is the Chain of Command
aware of the complaint?
1
CONTROLLED UNCLASSIFIED INFORMATION
When filled out, this document is subject to controls by USFF IG. Prior to release, please contact USFF IG for permission.
Gender
v
.June 2023