Da 7279 Form PDF Details

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QuestionAnswer
Form NameDa 7279 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesda form 7279, 7279 form, dd form 7279, da 7279

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EQUAL OPPORTUNITY AND HARASSMENT COMPLAINT FORM

For use of this form, see AR 600-20; the proponent agency is DCS, G-1.

PRIVACY ACT STATEMENT

AUTHORITY: 10 USC 7013, Secretary of the Army: DoDD 1350.2, Department of Defense Military Equal Opportunity (MEO) Program; DOD Instruction 1020.03 Harassment Prevention and Response in the Army in the Armed Forces; AR 600-20, Army Command Policy.

PRINCIPAL PURPOSE:

ROUTINE USES:

To provide a means for filing complaint based on discrimination due to (race, color, sex (to include gender identity), religion, national origin, or sexual orientation) and harassment due to (hazing, bullying, or other discriminatory harassment). Information provided will be used to process the discrimination or harassment complaint and will be shared with the Soldiers Commander. For additional information see the System of Records Notice A0600-20 SAMR, Soldiers Equal Opportunity Investigative Files (https://dpcld.defense.gov/Privacy/SORNsIndex/ DOD-Component-Notices/Army-Article-List/).

There are no specific routine uses anticipated for this form, however, it may be subject to a number of proper and necessary routine uses identified in the system of records notice specific in the purpose statement above.

DISCLOSURE: Voluntary, however, failure to provide all the requested information could lead to rejection of complaint for inadequate data.

1.

NAME

2. RANK

3.

UNIT

4.

RACE/ETHNIC GROUP

5. SEX

6.

DATE (YYYYMMDD)

PART I - COMPLAINT

7a. NATURE OF COMPLAINT. (Give, in as much detail as possible, the basis for your complaint; describe the incident/behavior(s) and date(s) of the occurrence(s); the names of parties involved, witnesses, and to whom it may have been previously reported; plus, any additional information that would be helpful in resolving your complaint. I understand submitting a false EO complaint is punishable under UCMJ. Attach additional sheets, as needed.)

7b. REQUESTED REMEDY. (What do you think the final outcome should be?)

8a. AFFIDAVIT.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I,

 

 

 

 

 

 

 

 

have read or have had read to me

this

statement which begins on this page (page 1) and ends on page

 

 

 

 

 

. I fully understand the contents of the entire

statement made by me. The statement is true. I have initialed all corrections. I

made the statement without threat of punishment,

and without coercion, unlawful influence, or unlawful inducement. I understand submitting a false EO complaint is punishable under UCMJ.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Signature of Person Making Statement)

Subscribed and sworn to before me, a person authorized by law to administer oaths, this

 

 

 

 

 

 

 

day of

 

 

,

 

 

at

 

 

 

 

 

 

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Signature of Person Administering Oath)

 

 

 

 

(Typed/Printed Name of Person Administering Oath)

 

8b. AGENCY RECEIVING COMPLAINT.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I acknowledge receipt of this complaint from

 

 

 

 

 

 

 

 

 

 

 

 

 

(name/rank)

of

 

 

 

 

 

 

 

(unit) on

 

 

(date).

I understand I have 3 calendar days (next drill period for reserve soldiers) in which to refer this complaint to the appropriate

commander of the complainant.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8c. NAME

 

 

 

 

 

 

8d. RANK

8e. DATE (YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8f. AGENCY

 

 

 

 

 

 

8g. SIGNATURE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DA FORM 7279, JUL 2020

PREVIOUS EDITIONS ARE OBSOLETE.

 

 

Page 1 of 2

APD AEM v1.00

9a.

ACKNOWLEDGEMENT.

 

I acknowledge receipt of this complaint, on behalf of (complainant's name)

 

,

submitted to me by (name, rank, alternative agency)

 

 

 

 

 

on

. I understand I have 5 calendar days (AC/RC) from the date of receipt in

 

which to initiate an investigation into the complaint, implement a plan to prevent reprisal, and reported complaint to the first SPCMCA when processed at the battalion or company level, or first GCMCA when processed at the brigade level and above. I also have 30 calendar days (three MUTA (90 days) - for USAR) in which to complete an investigation from the acknowledge date on the DA Form 7279. The legal sufficiency review will be conducted within 14 calendar days from the date the investigation is completed.

9b.

NAME

 

 

 

9c. RANK

 

 

9d. DATE (YYYYMMDD)

 

 

 

 

 

 

 

 

 

9e.

ORGANIZATION

 

 

 

9f. SIGNATURE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART II - RESULTS OF INVESTIGATION

 

 

 

10a.

I (name of commander)

 

 

 

 

reviewed the report of investigation into

 

 

 

 

 

your allegations. I

concur

nonconcur with the findings of the investigating officer. I find that your allegations are:

 

 

substantiated

unsubstantiated. I base my decision on the following points:

 

 

 

 

 

 

 

 

 

 

 

10b.

SIGNATURE OF COMMANDER

 

 

10c. DATE (YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART III - ACTIONS TO RESOLVE COMPLAINT

11a.

The command has done (or will do) the following actions to resolve this complaint and continue to prevent acts of reprisal:

11b. ADVISEMENT TO COMPLAINANT/SUBJECT: You have the right to appeal these actions to resolve the complaint. You will have 7 calendar days (next MUTA-4 for USAR) to submit your appeal in writing (timeline applies to both the first and second appeal requests.)

 

11c. SIGNATURE OF COMMANDER

11d. DATE (YYYYMMDD)

 

 

 

 

 

 

 

11e. ACKNOWLEDGEMENT BY THE COMPLAINANT AND SUBJECT(S) OF THE COMPLAINT OF FINDINGS, FEEDBACK, AND

 

APPEALS OPTIONS

 

 

 

 

 

 

 

 

 

 

 

 

 

(Signature of Complainant)

 

(Date)

 

 

 

 

 

 

 

 

 

(Signature of Subject(s) of Complaint)

 

(Date)

 

FOR ADDITIONAL SUBJECT(S) OF COMPLAINT, USE A BLANK SHEET OF PAPER.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART IV - APPEAL

 

 

 

 

 

12a. I elect to appeal the outcome of my complaint for the following reasons:

 

 

 

 

 

 

 

 

Continuation sheet(s) is attached

 

Continuation sheet(s) is not attached

 

 

 

 

 

 

 

 

 

12b. COMPLAINANT'S SIGNATURE

12c. DATE (YYYYMMDD)

 

 

 

 

12d. SUBJECT'S SIGNATURE

12e. DATE (YYYYMMDD)

 

 

 

 

12f. I have reviewed the complaint file, the investigative findings, and other information regarding this case. My findings are:

 

 

 

 

12g. SIGNATURE OF APPELLATE AUTHORITY

12h. DATE (YYYYMMDD)

 

 

 

 

 

 

 

12i. I acknowledge being counseled concerning the outcome of this appeal.

 

 

 

 

 

 

 

 

12j. COMPLAINANT'S SIGNATURE

12k. DATE (YYYYMMDD)

 

 

 

 

12l. SUBJECT'S SIGNATURE

12m. DATE (YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

DA FORM 7279, JUL 2020

 

 

 

Page 2 of 2

APD AEM v1.00

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Filling out section 1 of 7279 army

2. After this array of fields is complete, you have to insert the necessary specifics in Subscribed and sworn to before me, day of, Signature of Person Administering, TypedPrinted Name of Person, b AGENCY RECEIVING COMPLAINT I, unit on, I understand I have calendar days, namerank, date, c NAME, f AGENCY, d RANK, e DATE YYYYMMDD, g SIGNATURE, and DA FORM JUL allowing you to proceed further.

e DATE YYYYMMDD, Subscribed and sworn to before me, and d RANK of 7279 army

3. The next part is typically rather straightforward, a ACKNOWLEDGEMENT I acknowledge, on which to initiate an, I understand I have calendar, c RANK, d DATE YYYYMMDD, e ORGANIZATION, f SIGNATURE, a I name of commander your, concur, nonconcur with the findings of the, reviewed the report of, PART II RESULTS OF INVESTIGATION, substantiated, unsubstantiated I base my decision, and b SIGNATURE OF COMMANDER - every one of these empty fields needs to be filled out here.

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Be very attentive when filling in d DATE YYYYMMDD and concur, since this is the section where most people make a few mistakes.

4. Your next part will require your attention in the subsequent places: a The command has done or will do, PART III ACTIONS TO RESOLVE, b ADVISEMENT TO COMPLAINANTSUBJECT, d DATE YYYYMMDD, e ACKNOWLEDGEMENT BY THE, Signature of Complainant, Signature of Subjects of Complaint, Date, Date, FOR ADDITIONAL SUBJECTS OF, a I elect to appeal the outcome of, PART IV APPEAL, Continuation sheets is attached, and Continuation sheets is not attached. Ensure you enter all of the needed information to go forward.

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5. As a final point, the following final section is precisely what you should finish before using the form. The blank fields at issue are the next: b COMPLAINANTS SIGNATURE, d SUBJECTS SIGNATURE, c DATE YYYYMMDD, e DATE YYYYMMDD, Continuation sheets is attached, Continuation sheets is not attached, f I have reviewed the complaint, g SIGNATURE OF APPELLATE AUTHORITY, h DATE YYYYMMDD, i I acknowledge being counseled, j COMPLAINANTS SIGNATURE, l SUBJECTS SIGNATURE, DA FORM JUL, k DATE YYYYMMDD, and m DATE YYYYMMDD.

g SIGNATURE OF APPELLATE AUTHORITY, l SUBJECTS SIGNATURE, and f I have reviewed the complaint of 7279 army

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