About You

It’s up to you how much personal information to provide. Having your contact information will make it easier if we need to get more information about your complaint. Please read our Privacy Policy to learn more.
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Indicate if you are filing a report on behalf of another individual such as a friend, family member, or client. You will have the opportunity to document your information as well as the other individual’s information.

If you are filing on behalf of your small business or organization:

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Please select yes if you are currently a member of the armed forces or have been a member of the armed forces.