Instructions for Submitting a Complaint Form (Privacy Act)

Section 1: Complainant/Representative Information

If you are the complainant, you should complete the section “Complainant Information.” 

If you represent the complainant, you should complete the sections “Complainant Information” and “Representative Information,” as well as the authorization form.

Section 2: Details of Complaint

Please provide information about your complaint.

You should also describe any efforts you made, if any, to resolve the issue with the federal government institution concerned.

Section 3: Documentation

You can attach supporting documents to your online complaint or you can mail or fax paper documents separately. If you send your documentation at a later date, please include the reference number that you will receive when you submit this online complaint form.

Section 4: Review, Certification and Send

Please review and certify all the information you have provided in the complaint form before submitting it.

Section 5: Download for Your Records

If you file a complaint online, we strongly recommend that you download and save a copy of your complaint for your records.  You will have 10 minutes to download this PDF file of your complaint before it is removed from our web server for processing.

Keep in mind, however, that when you make a PDF copy on a computer, it will remain there until it is deleted. It is important to think about this if you are working on your complaint on a public computer, such as in a public library or an Internet café. In that case, once you have printed off a copy of the complaint, or e-mailed it to yourself, remember to delete the PDF file that you saved on that computer.