FY24 Online Complaint Form

FY24 Online Complaint Form

Contact Information

Although optional, providing a method for us to contact you is important as we may need additional information to pursue your complaint. We do not disclose information about individuals who contact us without their permission or unless required by law. Please select from one of the following three options regarding your contact information:

I will provide my contact information and give my permission for the OIG to share this information with another entity when necessary.

I will provide my contact information but request the OIG keep my information confidential and not share with outside entities.

I want to submit my complaint anonymously.

(Please keep in mind that your decision to elect anonymity may limit our ability to conduct an inquiry, if one is warranted, or to appropriately address your complaint. Please consider providing your name and/or contact information to allow for follow-up contact in the event our office needs additional information or clarification.)

First Name

Last Name

Phone Number

Phone

Email Address

Choose from the following (you may choose more than one):

I am complaining about a person

I am complaining about a program

(i.e. Rental Assistance, Senior Transportation, etc.)

I am complaining about a department or agency

(i.e. Transportation, Libraries, Recreation, etc.)

First Name of person involved*

If unknown, please put N/A

Last Name of person involved

If unknown, please put N/A

Email address of person involved, if known

Phone number of person involved, if known

Phone

Department, if known

Location, if known

Please provide the name of program or type of program*

Please select the name of the Montgomery County Department or Agency*

(you may choose more than one)

Select or enter value

When did this incident occur?*