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To claim reprisal please provide the following information:
Your Full Name:*
Bureau or Office:*
Best Contact Phone Number:*
Describe in detail the protected disclosure or protected activity you engaged in
and to whom the disclosure was made.*
When did the disclosure or protected activity occur (i.e. date, location, circumstances)?*
Provide the names and contact information of any witnesses to the disclosure, protected
activity and/or adverse personnel action.*
Describe in detail the adverse personnel action(s) that occurred or were threatened.*
Explain why and how the official who took or threatened to take an adverse personnel
action against you or failed to take a positive personnel action knew of the protected
disclosure or activity.*
Have you filed a complaint with the OSC or EEOC? If so, please provide the date
you filed the complaint and the status of the complaint.*
If you have challenged censorship or made disclosures related to the integrity of
the scientific process, have you filed a scientific integrity complaint pursuant
to DOI 305 DM 3? Please explain.*
Have you participated in mediation or conflict resolution concerning your complaint?
Do you wish to remain confidential?*
The OIG will protect the identity of complainants to the maximum extent possible
by law. Confidentiality is established by Section 7(b) of the
Inspector General Act of 1978, which precludes
the Inspector General from disclosing the identity of a DOI employee who reports
an allegation or provides information without the employee's consent, unless the
OIG determines that disclosure is unavoidable during the course of the investigation.
Non-DOI employees who report allegations may specifically request confidentiality.
Where whistleblower reprisal is alleged, confidentiality may also be extended pursuant
Whistleblower Protection Enhancement
and the DOI's policy on scientific integrity where scientific misconduct is alleged.
Privacy Act Notice
Our authority to request information concerning fraud, waste, and mismanagement
in connection with the programs and operations of the DOI is found in the
General Act of 1978, as amended, 5 U.S.C. App. 3, sec. 4. The OIG
uses submitted information for investigations or audits into fraud, waste, and mismanagement
in connection with the programs and operations of DOI and for education. We may
make disclosures of submitted information to other Federal and State Government
law enforcement agencies as necessary to complete our investigation, or as required
under Federal law. The OIG may refer your allegation to the appropriate law enforcement
or administrative agency if we believe the allegation is within their jurisdiction.
The OIG collects information in connection with training requests pursuant to the
IG Act and the WBPEA.
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