Fillable Form 1559 - Inspector General Action Request printable pdf download

Form 1559 - Inspector General Action Request

Download a blank fillable Form 1559 - Inspector General Action Request in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form 1559 - Inspector General Action Request with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

INSPECTOR GENERAL ACTION REQUEST

For use of this form, see AR 20-1; the proponent agency is the Office of The Inspector General.

DATA REQUIRED BY THE PRIVACY ACT OF 1974

AUTHORITY:

Title 10, USC, Section 3020; Inspector General Act of 1978 (Pub.L. 95-452), as amended; E.O. 9397 (SSN).

PRINCIPAL PURPOSE:

To secure sufficient information to inquire into the matters presented and to provide a response to the requestor(s) and /

or take action to correct deficiencies.

ROUTINE USES:

Information is used for official purposes within the Department of Defense; to answer complaints or respond to requests

for assistance, advice, or information; by Members of Congress and other Government agencies when determined by The

Inspector General to be in the best interest of the Army; and, in certain cases, in trial by courts-martial and other Military

matters as authorized by the Uniform Code of Military Justice. Department of Defense Blanket Routine Uses also apply.

DISCLOSURE OF THE SOCIAL SECURITY NUMBER AND OTHER PERSONAL INFORMATION IS VOLUNTARY. HOWEVER, FAILURE TO

PROVIDE COMPLETE INFORMATION MAY HINDER PROPER IDENTIFICATION OF THE REQUESTOR, ACCOMPLISHMENT OF THE REQUESTED

ACTION(S), AND RESPONSE TO THE REQUESTOR.

LAST NAME - FIRST NAME - MIDDLE INITIAL

GRADE / RANK

SSN

COMPONENT / STATUS

UNIT AND COMPLETE MILITARY ADDRESS

PREFERRED CONTACT TELEPHONE

(Duty, home, and / or cell)

PREFERRED MAILING ADDRESS (If different from military address, including ZIP Code)

E-MAIL ADDRESS (Optional)

(What do you want the IG to do for you?)

SPECIFIC ACTION REQUESTED

INFORMATION PERTAINING TO THIS REQUEST (Background. Use additional sheets if necessary; list enclosures if applicable.)

I do

I do not

consent to release my personal information outside of IG channels (but within DoD official channels) in order to resolve the

matters listed above. I understand that if I do not agree to release my personal information, my request for assistance may go unresolved.

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 Army. Those who knowingly and intentionally provide false statements on this form are

subject to potential punitive and administrative action (UCMJ Art 107, 18 USC 1001).

SIGNATURE

DATE (YYYYMMDD)

APD LC v1.00ES

DA FORM 1559, JUL 2011

PREVIOUS EDITIONS ARE OBSOLETE.