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Online Complaint

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THIS ONLINE COMPLAINT PAGE HAS A 60 MINUTE AUTO-TIMEOUT.

If the complaint is not completed within 60 minutes, the OEIG may not receive your application.

indicates required field

Your First Name

Your Last Name

Age

Sex

Male
Female

Street Address (Include Apt. #/Unit #, if applicable)

City

State

Zip Code

Home Phone

Business Number

Other Number

E-mail

Contact PreferenceWhat is your preferred method of contact?

EmploymentAre you employed by the State of Illinois, a State public university, CTA, Metra, PACE, or RTA?

Yes
No

Agency of EmploymentIf yes, which agency?

Job Title

Complaint Against AgencyIs your complaint against an employee(s), agency, or someone doing business with the State of Illinois, CTA, Metra, PACE, or RTA?

Yes
No

AgencyIf yes, which agency?

Notified OthersHave you notified any other Federal, State or local agency of your complaint or filed a lawsuit or grievance related to these matters?

Yes
No

Agency NotifiedIf yes, with which agency did you file a complaint?

Agency Complaint NumberWhat is the complaint number?

Complaint ResolvedHas your complaint been resolved?

Yes
No

Resolution SummaryIf yes, briefly summarize the results

Previous Complaint FiledHave you previously filed a complaint with the OEIG?

Yes
No

OEIG Case NumbersIf yes, please list any known OEIG case numbers

Related ComplaintIs this complaint related to your previously filed OEIG complaint?

Yes
No

Reveal Name in ReferralIf your complaint is referred, do you consent to the release of your identity as the complainant?

Yes
No

Reveal Name in ReportIf the OEIG conducts an investigation and issues a report, do you consent to being identified as the complainant in that report?

Yes
No

Subject's First Name

Subject's Last Name

Subject's Phone

Subject's Age

Subject's Sex

Male
Female

Subject's Street Address

Subject's City

Subject's State

Subject's Zip

Subject's Agency

Subject's Job Title

Subject's Additional Information

2nd Subject's First Name

2nd Subject's Last Name

2nd Subject's Phone

2nd Subject's Age

2nd Subject's Sex

Male
Female

2nd Subject's Street Address

2nd Subject's City

2nd Subject's State

2nd Subject's Zip

2nd Subject's Agency

2nd Subject's Job Title

2nd Subject's Additional Information

3rd Subject's First Name

3rd Subject's Last Name

3rd Subject's Phone

3rd Subject's Age

3rd Subject's Sex

Male
Female

3rd Subject's Street Address

3rd Subject's City

3rd Subject's State

3rd Subject's Zip

3rd Subject's Agency

3rd Subject's Job Title

3rd Subject's Additional Information

4th Subject's First Name

4th Subject's Last Name

4th Subject's Phone

4th Subject's Age

4th Subject's Sex

Male
Female

4th Subject's Street Address

4th Subject's City

4th Subject's State

4th Subject's Zip

4th Subject's Agency

4th Subject's Job Title

4th Subject's Additional Information

Summary of Complaint RequiredPlease summarize your complaint including date and time of alleged incident(s) (please attach any available documentation or other evidence in support of your complaint)

Witness First Name

Witness Last Name

Witness Agency

Witness Job Title

Witness Phone

Witness Additional Information

2nd Witness First Name

2nd Witness Last Name

2nd Witness Agency

2nd Witness Job Title

2nd Witness Phone

2nd Witness Additional Information

3rd Witness First Name

3rd Witness Last Name

3rd Witness Agency

3rd Witness Job Title

3rd Witness Phone

3rd Witness Additional Information

4th Witness First Name

4th Witness Last Name

4th Witness Agency

4th Witness Job Title

4th Witness Phone

4th Witness Additional Information

AttachmentsMultiple files can be uploaded by holding down Shift or Ctrl while selecting.

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Complaints

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