Office of the Auditor General Inspector General


Please type or clearly print information.




You are not required to provide information about yourself.  The Inspector General accepts anonymous complaints.  If you choose to provide information about your identity, there may be circumstances under which your identity may be revealed (for instance, if your complaint is referred to a law enforcement agency).  

Individuals who file complaints are not normally informed of the existence, status or outcome of an investigation.  Generally, you will only be contacted again if there is a need for additional information or clarification.

The Inspector General does not represent any party or agency in an investigation and does not investigate “on behalf” of any individual or agency. If an individual is seeking legal representation, she or he should consult with an attorney.



Your name: ______________________________________ Date:________________



Street Address



City                                          State                                                    Zip Code



􀂉 Phone: ___________________________


􀂉 E-mail:_____________________________



Are you a State of Illinois employee?     􀂉 Yes              􀂉 No


If “YES”, which agency?:_________________________________________________________


Is the alleged violation related to your State employment?                      􀂉 Yes              􀂉 No




Is your complaint against an employee of the Office of the Auditor General?      􀂉Yes         􀂉 No


If “NO”, this office lacks the authority to review or investigate the alleged violation and the complaint will be returned or referred to the appropriate authority.  If “YES”, complete the following concerning the nature of the alleged violation.


Please provide as much detailed information as possible about the person who committed the alleged violation:


Subject’s Name:__________________________________ Phone:________________________


Title (if known):________________________________________________________________



Street Address


City                                                                  State                            Zip Code


Have you notified any other Federal, State or local agency of your complaint or filed a lawsuit or grievance related to these matters?           􀂉 Yes              􀂉 No


            If yes, with what agency did you file a complaint?          ______________________________


            What is the complaint number?______________________________________________


Has your complaint been resolved?   􀂉 Yes                  􀂉 No


If yes, briefly summarize the results:________________________________________________



May we refer your complaint to the appropriate agency if necessary?     􀂉 Yes              􀂉 No

Please be aware that complaints relating to management issues may be referred back to the agency.  Once your complaint is referred, you may be contacted by that agency as part of its investigation.


Please (1) describe the acts and circumstances that surrounded the alleged violation; (2) state the date and time of the alleged violation; (3) state the names of any other persons who witnessed or participated in the alleged violation; (4) provide any other relevant information; and (5) submit any relevant materials. (Add additional pages if necessary)



Other person(s) who could be a witness to the complaint you have alleged:





Any other identifying information (Agency, Title, Phone Number, etc.)





Any other identifying information (Agency, Title, Phone Number, etc.)



If you have identified yourself, your identity as the person reporting an alleged violation is confidential unless you waive confidentiality or unless disclosure is required by law or rule.  This right of confidentiality does not preclude the disclosure of the identity of a person in any capacity other than as the source of an allegation.


Do you wish to waive your right to confidentiality?         􀂉 Yes              􀂉 No


If “YES”, please sign here: _______________________________________________________



The Office of the Auditor General's Inspector General's investigatory files and reports are confidential and exempt from disclosure under the Freedom of Information Act, but may be shared as permitted and appropriate for the proper conduct and conclusion of an investigation.  Upon conclusion of an investigation, a report regarding the investigation may be completed and provided to the head of the State agency responsible for managing the complaint or carrying out any recommended actions.  When supported by investigative findings, an investigative report may also be provided to the Attorney General or a law enforcement agency for review, to determine whether or not the underlying facts support a criminal prosecution.



Return completed form by mail to:

Don Kliment

Office of the Auditor General Inspector General

740 E. Ash St., Springfield, IL 62703

Phone: 217/782-6046; TTY:  888/261-2887

Please mark your envelope "confidential."


Any person who intentionally makes a false report alleging a violation of the State Officials and Employees Ethics Act to an ethics commission, an inspector general, the State Police, a State’s Attorney, the Attorney General, or any other law enforcement official is guilty of a Class A misdemeanor. 5 ILCS 430/50-5(d).


SIGNATURE (optional):______________________________Date:_______________________