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, except for

allegations of reprisal. 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?

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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
U.S. FLEET FORCES COMMAND OFFICE OF THE INSPECTOR GENERAL

FRAUD, WASTE, ABUSE, & MISMANAGEMENT COMPLAINT FORM

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CONTROLLED UNCLASSIFIED INFORMATION

When filled out, this document is subject to controls by USFF IG. Prior to release, please contact USFF IG for permission. 

SECTION III - SUBJECT INFORMATION (SUBMIT ADDITIONAL PAGES AS NEEDED) 

SUBJECT 1 

Last Name First Name MI

Subject Status Grade or Rank Organization (i.e. Dept/Division/Code)

SUBJECT 2 

Last Name First Name MI

Subject Status Grade or Rank Organization (i.e. Dept/Division/Code)

SUBJECT 3 

Last Name First Name MI

Subject Status Grade or Rank Organization (i.e. Dept/Division/Code)

Allegations Appropriate for an Inspector General

Please review the information below for examples of allegations that may be appropriate for a Navy Inspector General before proceeding.

- Abuse of Title or Position

- Bribes/Kickbacks/Acceptance of Gratuities

- Conflicts of Interest

- Ethics Violations

- False Official Statements/Claims

- Fraud

- Gifts (Improper receipt or giving)

- Mismanagement/Organization Oversight (Significant Cases)

- Misuse of Official Time, Gov’t Property, Position and Public

Office

- Political Activities

- Purchase Card Abuse

- Reprisal/Restriction (Military Whistleblower Protection)

- Safety/Public Health (Substantial/Specific)

- Systemic Problems

- Time and Attendance (Significant Violations)

- Travel Card Abuse

- Travel Fraud (TDY and TAD)

- Waste (Gross)

Please be aware that we are not a law enforcement agency. Any allegations of criminal wrongdoing should be sent to the 

appropriate law enforcement agency, such as NCIS (www.ncis.navy.mil).

Emergencies should be reported to your local public safety office or 911. 
U.S. FLEET FORCES COMMAND OFFICE OF THE INSPECTOR GENERAL

FRAUD, WASTE, ABUSE, & MISMANAGEMENT COMPLAINT FORM

SECTION IV - ALLEGATION INFORMATION (SUBMIT ADDITIONAL PAGES IF YOU NEED MORE SPACE) 

What was done or not done that was wrong? Please be as specific as you can, including which subject did what.

Where did this occur? Please be as specific as you can, including all locations and related information.

When did this occur? Please be as specific as you can, including all dates and times in chronological order.

How did this occur?

Why did this occur?

Who witnessed the wrongdoing? (Include first and last names, rank/pay grade, place of employment, etc.)

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CONTROLLED UNCLASSIFIED INFORMATION

When filled out, this document is subject to controls by USFF IG. Prior to release, please contact USFF IG for permission. 

What law, rule or regulation do you think was violated? (if known)?
U.S. FLEET FORCES COMMAND OFFICE OF THE INSPECTOR GENERAL

FRAUD, WASTE, ABUSE, & MISMANAGEMENT COMPLAINT FORM

SECTION V - ADDITIONAL INFORMATION 

Have you contacted another official, or do you intend to use another process, e.g., congressional, EEO, chain-ofcommand or another IG to resolve this matter? If yes, please identify the official or process and the current status of 

the matter. 

Briefly describe how you believe this office can assist you with your complaint.

For each additional document you are providing, please provide a title, date, description of content, and its relevancy.

Have you read the "Allegations Appropriate for an Inspector General" description on the bottom of page 2?

No, I have not. 

 Yes, I have. 

No, I do not. 

Yes, I do. 

By submitting this form, you certify all statements made in this complaint are true, complete, and correct to the best of 

your knowledge and / or belief. You understand that your complaint will not be reviewed if you fail to certify this 

document by selecting the appropriate response below, or if you select the not certify option. You further 

understand that a false statement or concealment of a material fact is a criminal offense (18 U.S.C. Section 1001; 

Inspector General Act of 1978, as amended, Section 7; and / or the Uniform Code of Military Justice, Article 107). 

This information is submitted for the basic purpose of requesting assistance, correcting injustices affecting the 

individual, or eliminating conditions considered detrimental to the efficiency or reputation of the Navy. 

No, I do not so certify. 

Yes, I so certify.

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CONTROLLED UNCLASSIFIED INFORMATION

When filled out, this document is subject to controls by USFF IG. Prior to release, please contact USFF IG for permission. 

Do you believe your allegations fall into the category of allegations appropriate for an Inspector General?
U.S. FLEET FORCES COMMAND OFFICE OF THE INSPECTOR GENERAL

FRAUD, WASTE, ABUSE, & MISMANAGEMENT COMPLAINT FORM

SECTION VI - PRIVACY ACT INFORMATION

DATA REQUIRED BY THE PRIVACY ACT OF 1974

PRIVACY ACT STATEMENT For Personal Information Taken During Inspector General Interviews.

AUTHORITY: Title 10 US Code, Sections 5014 and 5020.

PURPOSE: To determine the facts and circumstances surrounding allegations or complaints against Navy/Marine Corps 

personnel and/or activities. To present findings, conclusions and recommendations developed from investigations and other 

inquiries to the Secretary of the Navy, CNO, CMC, or other appropriate commanders. Disclosure of Social Security Account 

Number is voluntary, and if requested, is used to further identify the individual providing the information.

ROUTINE USES: The information is used for the purpose set forth above and may be:

a. Forwarded to federal, state or local law enforcement agencies for their use;

b. used as a basis for summaries, briefings or responses to Members of Congress or other agencies in the Executive

Branch of the Federal Government;

c. provided to Congress or other federal, state and local agencies, when determined necessary.

MANDATORY OR VOLUNTARY DISCLOSURE AND EFFECT ON INDIVIDUAL NOT PROVIDING INFORMATION:

a. For Military Personnel: Disclosure of personal information is mandatory and failure to do so may subject the individual

to disciplinary action.

b. For Department of the Navy Civilians: Failure to disclose personal information in relation to your position responsibilities

may subject the individual to adverse personnel action.

c. For All Other Personnel: Disclosure of personal information is voluntary and no adverse action can be taken against

individuals for refusing to provide information about themselves.

ACKNOWLEDGEMENT

I understand the provisions of the Privacy Act of 1974 as related to me through the foregoing statement.

Submit completed forms along with all supporting documents to:

Email: USFFOIG@us.navy.mil

Hotline: 1-800-533-2397

Fax: 757-836-3570

Mail: U.S. Fleet Forces Command

ATTN: Office of the Inspector General

1562 Mitscher Ave, Suite 250

Norfolk, VA 23551

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CONTROLLED UNCLASSIFIED INFORMATION

When filled out, this document is subject to controls by USFF IG. Prior to release, please contact USFF IG for permission. 

Signature Date

THANK YOU FOR BRINGING THIS COMPLAINT TO OUR ATTENTION
U.S. FLEET FORCES COMMAND OFFICE OF INSPECTOR GENERAL

FRAUD, WASTE, ABUSE, & MISMANAGEMENT COMPLAINT FORM

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CONTROLLED UNCLASSIFIED INFORMATION

When filled out, this document is subject to controls by USFF IG. Prior to release, please contact USFF IG for permission. 

SECTION VII – Additional Allegation Information Writing Area 

This area is for you to provide additional information that would not fit within the boxes above: