Whistleblower Reprisal Complaint Form

For more information regarding your rights and responsibilities under the whistleblower protection laws, please refer to our Whistleblower Rights & Protections page.

If you believe you have been retaliated against for disclosing misconduct involving the U.S. Office of Personnel Management, please complete and submit this form by pressing the SUBMIT button below. If you are unable to submit this form directly online, you may select one of the alternative methods listed at the bottom of this form.

Name

Title/Grade

Email

Phone

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

What is your current status?

Applicant for employment

Current OPM employee

Former OPM employee

Employee of a contractor, subcontractor, or OPM grantee

Not a federal employee, but your employer received Recovery Act funds

Other…

If you are unable to submit this form directly online, you may select one of the below alternative methods:

Telephone: (202) 606 - 1200
US Mail: Complete and mail this form and any supporting documents to:

1900 E Street, NW
Room 6400
Washington, D.C. 20415-1100

Whistleblower Reprisal Complaint Form

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