OSI Complaint Form » NYS Department of Corrections and Community Supervision

To file a complaint with DOCCS Office of Special Investigations (OSI), please complete the below form. We will be unable to process incomplete entries.

The below form is for complaints to the OSI. New York State Freedom of Information Law (FOIL) requests must be submitted using the New York State Freedom of Information Law Request form. General inquiries must be submitted using the Contact Us form.

Your Information

Fields marked with an asterisk (*) are required.

*Your First Name

*Your Last Name

*Street Address

*City

*State

*Zip Code

*Email Address

*Phone Number (Format:222-222-2222):

Request Confidentiality

Anonymous Complaints

WHAT HAPPENED: *A description of the incident is required
(500 words or less):

LOCATION OF THE INCIDENT:

Correctional Facility:

Community Supervision Area Office:

Other Location or Description of Specific Location:

DATE & TIME OF INCIDENT: An approximate date and time is acceptable:

WHO WAS PRESENT DURING THE INCIDENT:

Identifying all persons present is helpful.

Victim's Information:

First Name:

Last Name:

if an inmate/parolee, include Department ID Number (Format:99A9999):

If a DOCCS' employee, please detail of who it is:

If other please provide detail of who it is:

First Name:

Last Name:

if an inmate/parolee, include Department ID Number (Format:99A9999):

If a DOCCS' employee, please detail of who it is:

If other please provide detail of who it is:

First Name:

Last Name:

if an inmate/parolee, include Department ID Number (Format:99A9999):

If a DOCCS' employee, please detail of who it is:

If other please provide detail of who it is:

If more than three (3) Victims please check box:

Perpetrator's Information:

First Name:

Last Name:

if an inmate/parolee, include Department ID Number (Format:99A9999):

If a DOCCS' employee, please detail of who it is:

If other please provide detail of who it is:

First Name:

Last Name:

if an inmate/parolee, include Department ID Number (Format:99A9999):

If a DOCCS' employee, please detail of who it is:

If other please provide detail of who it is:

First Name:

Last Name:

if an inmate/parolee, include Department ID Number (Format:99A9999):

If a DOCCS' employee, please detail of who it is:

If other please provide detail of who it is:

If more than three (3) Perpetrators please check box:

Witness(es) Information:

First Name:

Last Name:

if an inmate/parolee, include Department ID Number (Format:99A9999):

If a DOCCS' employee, please detail of who it is:

If other please provide detail of who it is:

First Name:

Last Name:

if an inmate/parolee, include Department ID Number (Format:99A9999):

If a DOCCS' employee, please detail of who it is:

If other please provide detail of who it is:

First Name:

Last Name:

if an inmate/parolee, include Department ID Number (Format:99A9999):

If a DOCCS' employee, please detail of who it is:

If other please provide detail of who it is:

If more than three (3) Witnesses please check box:

Names Others Involved Not Listed Above:

If you know the identity of any other person not identified above who was involved in the incident or has information regarding the incident, please provide his/her name and any contact information (e.g., phone number) in the box below.

Limit 100 words or less)

DISCLAIMER:

Those filing a complaint with the Office of Special Investigations (OSI) are strongly encouraged to identify him or herself in the event that additional questions arise. The OSI has a strict policy to maintain confidentiality within the bounds of the law of any complaint who requests confidentiality. A Confidential complainant's identity will not be disclosed unless the complainant consents to the disclosure or the OSI is required by law or court order to disclose the complainant's identity. In addition, "whistle-blower" protection pursuant to New York State law may apply to a State Employee who reports misconduct.

If you use the On-line Complaint Form or sent an email to the OSI, please review our Privacy Policy.

NYS DOCCS OSI Complaint Form

Identifying all persons present is helpful.

Victim's Information:

Perpetrator's Information:

Witness(es) Information: