DA Form 7279: Equal Opportunity and Harassment Complaint Form

Fill in 1. NAME, 2. RANK, 3. UNIT, 4. RACE/ETHNIC GROUP, 5. SEX and 6. DATE (YYYYMMDD).

In 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. Attach additional sheets, as needed.

In 7b. REQUESTED REMEDY: What do you think the final outcome should be?

In DA Form 7279, Requested Remedy, the complainant will enter the requested resolution, which the commander may take into consideration upon completion of the inquiry or investigation, and when considering resolution actions.

Submitting a false EO complaint is punishable under UCMJ.⁠^[2]

In 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.

SIGN (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).

In 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.

Then fill in 8c. NAME, 8d. RANK, 8e. DATE (YYYYMMDD), 8f. AGENCY and 8g. SIGNATURE.

In 9a. ACKNOWLEDGEMENT, I acknowledge receipt of this complaint, on behalf of (complainant's name), submitted to me by (name, rank, alternative agency).

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.

Fill in 9b. NAME, 9c. RANK, 9d. DATE (YYYYMMDD), 9e. ORGANIZATION and 9f. SIGNATURE.

In 10a, I concur nonconcur with the findings of the investigating officer. I find that your allegations are: substantiated unsubstantiated.

In 11a, the command has done (or will do) the following actions to resolve this complaint and continue to prevent acts of reprisal:

In 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.)

In 11e. ACKNOWLEDGEMENT BY THE COMPLAINANT AND SUBJECT(S) OF THE COMPLAINT OF FINDINGS, FEEDBACK, AND APPEALS OPTIONS, the complainant and subject will sign and date the DA Form 7279, Part III, to acknowledge receiving this information.⁠^[2]

The complainant or subject must provide a brief statement that identifies the basis of the appeal. This will be done in writing on the DA Form 7279 and will be returned to the commander in the chain of command who either conducted the investigation or appointed the investigating officer or the commander who conducted the first appeal.

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

The final appeal authority may sustain or overrule the finding(s) or remand the matter for further fact finding.

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

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

Fill in 12b. COMPLAINANT'S SIGNATURE, 12c. DATE (YYYYMMDD), 12d. SUBJECT'S SIGNATURE, 12e. DATE (YYYYMMDD), 12g. SIGNATURE OF APPELLATE AUTHORITY, 12h. DATE (YYYYMMDD), 12j. COMPLAINANT'S SIGNATURE, 12k. DATE (YYYYMMDD), 12l. SUBJECT'S SIGNATURE and 12m. DATE (YYYYMMDD).⁠^[2]