I.G. Office - National Intelligence Agency

Statements of the Complainant/Applicant

Select an option:

Blind

Deaf

Illeterate

Personal Information

Name:

CPR/Passport:

Nationality:

Gender:

Date of Birth

Occuption

Employer

Address Information

Flat:

Building:

Road:

Block:

Area:

Governorate:

Contact Information

Work Number:

Home Number:

Mobile Number:

Email Address:

Submitter Information

Name:

CPR:

Phone Number:

Relation:

Occupation:

Other Number:

Email Address:

Complainant Information

It is preferable to provide us with information about the member of the National Intelligence Service against whom you wish to file a complaint, or any special specifications

It is known

UnKnown

Rank:

Job Number:

Name:

Security Agency He Belongs to:

Other Information:

Place and date of incident

Flat:

Building:

Road:

Block:

Area:

Governorate:

Date:

Witness Information

Do you have witnesses to the incident?

Yes

Name of the First Witness:

Private Number:

Phone Number:

Name of the First Witness:

Private Number:

Phone Number:

Complaints to other body

Have you filed a complaint with any other official body?

Yes

Side:

Date:

Followup Number:

Side:

Date:

Followup Number:

A detailed explanation of the incident of the complaint or request

Q: What is the relationship of the National Intelligence Service to your complaint? At your request.

Q: What are your specific requests?.

A detailed explanation of the incident of the complaint or request

Describe the circumstances that led to you feeling that the behavior of a National Intelligence Service member was inappropriate for you, and specifically what was said and done.
Provide any information or evidence to support the complaint you have filed.
Mention the psychological damages or physical injuries, if any.
Please remember to include your full name, date and signature on all pages.

Q: What is your complaint or request?.

Q: When and where did the incident occur?.

I have no objection to passing the above information to the relevant authorities and attending whenever I am summoned

Name:

Date:

Please send the following document with the this grenerated form

A copy of the passport or smart card of the complainant/s. Any .
Supporting document .