Office of the Legislative Inspector General
CASE INITIATION FORM
Please type or clearly print information.
Information About Complainant:
Your contact information (optional):
Preferred title: Mr. Ms. Mrs.
City State Zip Code
Please check one or more preferred methods of contact:
Home Phone: Business Phone:
Other Phone: E-mail:
Are you a State of Illinois employee? Yes No
If “YES”, which agency?:
Is the alleged violation related to your State employment? Yes No
Information About Alleged Violation:
Was the alleged violation by a member of the Illinois General Assembly or a State employee who is under the jurisdiction of a
legislative leader, the Senate Operations Commission, or the Joint Committee on Legislative Support Services? Yes No
*If “NO”, this office lacks the authority to review or investigate the alleged violation but will refer it to the appropriate authority.
If “YES”, complete the attached sheet concerning the nature of the alleged violation.
Waiver of Confidentiality:
Your identity as the person reporting an alleged violation is confidential unless you waive confidentiality or unless required by law.
Do you wish to waive your right to confidentiality? Yes No
If “YES”, please sign and return the optional Waiver of Right to Confidentiality.
Materials Exempt from Disclosure:
The Legislative Inspector General’s investigatory files and reports are confidential and exempt from disclosure under the
Freedom of Information Act. Allegations, pleadings, and related documents are exempt from disclosure under the Freedom
of Information Act so long as the Commission does not make a finding of a violation.
Where to Return this Form:
Please return form by mail or email: Office of the Legislative Inspector General, P.O. Box 381, Petersburg, IL 62675.
Phone: 217/558-1560, E-mail: firstname.lastname@example.org