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Office of Executive Inspector General for the Agencies of the Illinois Governor
Online Complaint
Your Name
Age
Sex
Sex
Male
Female
Street Address
City
State
Zip Code
Home Phone
Business Number
Other Number
E-mail
Contact Preference
What is your preferred method of contact?
Employment
Are you an employee of the State of Illinois, CTA, Metra, PACE, or RTA?
Employment
Yes
No
Agency of Employment
If yes, which agency?
Complaint Agency
Is your complaint against an employee(s), agency, or vendor of the State of Illinois, CTA, Metra, PACE, or RTA?
Complaint Agency
Yes
No
Agency
If yes, which agency?
Subject's Name
Person against whom you are complaining
Subject's Phone
Subject's Age
Subject's Sex
Subject's Sex
Male
Female
Subject's Street Address
Subject's City
Subject's State
Subject's Zip
2nd Subject's Name
Person against whom you are complaining
2nd Subject's Phone
2nd Subject's Age
2nd Subject's Sex
2nd Subject's Sex
Male
Female
2nd Subject's Street Address
2nd Subject's City
2nd Subject's State
2nd Subject's Zip
3rd Subject's Name
Person against whom you are complaining
3rd Subject's Phone
3rd Subject's Age
3rd Subject's Sex
3rd Subject's Sex
Male
Female
3rd Subject's Street Address
3rd Subject's City
3rd Subject's State
3rd Subject's Zip
4th Subject's Name
Person against whom you are complaining
4th Subject's Phone
4th Subject's Age
4th Subject's Sex
4th Subject's Sex
Male
Female
4th Subject's Street Address
4th Subject's City
4th Subject's State
4th Subject's Zip
Notified Others
Have you notified any other Federal, State or local agency of your complaint or filed a lawsuit or grievance related to these matters?
Notified Others
Yes
No
Agency Notified
If yes, with which agency did you file a complaint?
Agency Complaint Number
What is the complaint number?
Complaint Resolved
Has your complaint been resolved?
Complaint Resolved
Yes
No
Resolution Summary
If yes, briefly summarize the results
Previous Complaint
Have you previously filed a complaint with the OEIG?
Previous Complaint
Yes
No
OEIG Case Numbers
If yes, please list any known OEIG case numbers
Related Complaint
Is this complaint related to your previously filed OEIG complaint?
Related Complaint
Yes
No
Remove Name
If your complaint is referred, do you want your name and contact information removed?
Remove Name
Yes
No
Whistle Blower Protection Claim
Please be advised that in order to conduct a thorough investigation involving a Whistle Blower Protection claim, the OEIG may need to disclose your identity. Do you agree to the disclosure of your identity as complainant?
Whistle Blower Protection Claim
Yes
No
N/A
Reveal Name
If the OEIG conducts an investigation, it may forward a report to the affected agency with recommendations for policy/procedure changes and/or discipline. In order to implement the recommendations, the agency may need to contact you. If so, may we reveal your name and contact information to the agency?
Reveal Name
Yes
No
Summary of Complaint
Summary of your complaint including date and time of alleged incident(s) (please attach any available documentation in support of your complaint)
Witness
Please list other person(s) who could be a witness to the misconduct you have alleged.
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