New York National Guard
Inspector General Assistance Request Form

You should make an effort to use your unit and chain of command to resolve issues
BEFORE using this form.

Please read this Privacy Act Information before submitting this form.

**  Denotes a required field.

Name First:**    Last:**    Rank (If applicable):
Address
Contact Information Primary Phone:**     Alternate Phone:

Email:
Status Current Duty Status:    Unit (If applicable):
To whom have you spoken about this matter? ** Identify (First Sergeant, Company Commander, etc.)
What do you want the IG to do for you? ** (Be specific and provide supporting information)
Do you have any supporting documentation? ** (Must be prepared to submit when an IG contacts you)
Have you requested assistance from any other source or agency? ** (e.g. Military Personnel or your Senator)
By submitting this form, you acknowledge that you have read and understand the Privacy Act Information.

  
© NYS DMNA: NY National Guard IG Assistance Form
URL: http://dmna.ny.gov/ig/ig_form.php
Page Last Modified: 29 Oct 10 (ba)