text goes here You must have JavaScript enabled to use this form. Contact Permission - Please Choose One If necessary, you may contact me for additional information, but please keep my name confidential and do not share it outside of the Office of Inspector General If necessary, you may contact me for additional information and I do not place any restrictions on the release of my contact information. I wish to remain anonymous Complainant Contact Information Your Name Your Name Address Address City/Town State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Phone Number Email What Grantee, Grantee Employee, or LSC Employee does your allegation involve* Description of Complaint Names of Witness(es) Leave this field blank
