Form Da 2590 PDF Details

In an era where the accessibility and functionality of government forms directly impact millions, the DA Form 2590 stands out as a crucial document within the U.S. Department of Defense's administrative framework. This form, officially titled "Formal Complaint of Discrimination," serves a pivotal role in the formal filing process for complaints of discrimination based on race, color, national origin, religion, sex, age, physical or mental disability, and/or reprisal. It is designed specifically for use by Department of the Army civilian employees, former employees, applicants for employment, and some contract employees seeking justice and resolution. The form's structure and instructions underscore the government's commitment to addressing and rectifying instances of workplace discrimination, providing a clear pathway for aggrieved individuals to voice their concerns. However, the broader context of frustrations encountered by users of government PDF forms—highlighted by issues of accessibility, savability, and the overall quality of many federal forms—casts a shadow over the process. Despite these challenges, advancements in form technology, such as the Insert-Text-Anywhere-on-Page (ITAOP) method, offer a glimmer of hope for a more fluid and user-friendly experience. The provision for electronic submission, although not universally applied, marks a significant step towards modernizing and streamlining the complaint resolution process. This enables individuals impacted by discrimination within the Army to navigate the procedural aspects more efficiently, ensuring their concerns are formally recognized and adequately addressed.

QuestionAnswer
Form NameForm Da 2590
Form Length5 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 15 sec
Other namesitaop which pdf, form 2590, dod da 2004, dod da fillable pdf

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U.S. DoD Form DA-2590, Fillable, Savable, Version ITAOP

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FORMAL COMPLAINT OF DISCRIMINATION

For use of this form, see AR 690-600; the proponent agency is OSA

PRIVACY ACT STATEMENT (5 U.S.C. §552A)

AUTHORITY:

Public Law 92-261

PRINCIPAL PURPOSE: Used for formal filing of complaints of discrimination because of race, color, national origin, religion, sex, age, physical or mental disability, and/or reprisal by Department of the Army civilian employees, former employees, applicants for employment, and some contract employees.

ROUTINE USES: Information will be used (a) as a data source for complaint information for production of summary descriptive statistics and analytical studies of complaints processing and resolution efforts; (b) to respond to general requests for information under the Freedom of Information Act; (c) to respond to requests from legitimate outside individuals or agencies (Congress, White House, Equal Employment Opportunity Commission) regarding the status of an EEO complaint or appeal; or (d) to adjudicate an EEO complaint or appeal.

DISCLOSURE: Voluntary, however, failure to complete all appropriate portions of the form may lead to rejection of complaint on the basis of inadequate data on which to continue processing.

1.NAME (Last, First, Middle Initial)

2. SOCIAL SECURITY NUMBER

3. HOME TELEPHONE NUMBER

4. HOME ADDRESS

5.DO YOU CURRENTLY WORK FOR THE FEDERAL GOVERNMENT?

NO

YES (If yes, complete 6, 6a, 6b, 7 and 8.)

6. NAME OF AGENCY WHERE CURRENTLY EMPLOYED

6a. WORK TELEPHONE NUMBER

6b. EMPLOYER'S ADDRESS (Complete information to include office symbol.)

7. PAY PLAN/SERIES/GRADE

8. CURRENT JOB TITLE

SECTION I - COMPLAINT INFORMATION

9. REASON YOU BELIEVE YOU WERE DISCRIMINATED AGAINST (Check below all that apply. Identify specific race, color, sex, age, religion, national

origin, and/or disability.)

RACE

DATE OF BIRTH

DISABILITY Mental

COLOR

 

 

SEX

 

Male

 

 

 

Female

 

 

AGE

 

 

 

 

NATIONAL ORIGIN

 

 

 

 

 

 

 

RELIGION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PhysicalREPRISAL

(Date(s) and type of prior EEO activity)

10.EXPLAIN WHEN AND HOW YOU WERE DISCRIMINATED AGAINST (If your complaint involves more than one basis of alleged discrimination, list and number each basis separately and provide specific factual information in support of each allegation of discrimination. If necessary, continue on page 2.)

DA FORM 2590, FEB 2004

REPLACES DA FORM 2590-R, AUG 89, WHICH IS OBSOLETE.

PAGE 1 OF 3

APD V1.00

 

 

EXPLAIN WHEN AND HOW YOU WERE DISCRIMINATED AGAINST (Cont'd) (If necessary, additional sheets may be used.)

11a. NAME OF ORGANIZATION WHERE ALLEGED DISCRIMINATION OCCURRED

11b. ADDRESS OF ORGANIZATION WHERE ALLEGED DISCRIMINATION OCCURRED

12a. HAVE YOU DISCUSSED THE ISSUE(s) IN BLOCK 10 WITH AN EEO COUNSELOR? 12c, and 12d below.)

NO

YES (If yes, complete 12b,

12b. NAME OF EEO COUNSELOR

12c. DATE OF INITIAL CONTACT WITH EEO

OFFICIAL (YYYYMMDD)

12d. DATE NOTICE OF RIGHT TO FILE A FORMAL COMPLAINT OF DISCRIMINATION RECEIVED (YYYYMMDD)

13. ELECTION OF REPRESENTATION

ATTORNEY

NON-ATTORNEY

NO REPRESENTATION

NAME OF REPRESENTATIVE

ADDRESS

TELEPHONE NUMBER:

 

FAX:

 

E-MAIL:

 

 

 

 

 

 

14.WHAT RELIEF ARE YOU SEEKING TO RESOLVE THIS COMPLAINT? (State specific corrective action desired for each allegation.)

15a. HAVE THE ISSUES IDENTIFIED IN BLOCK 10 BEEN APPEALED TO THE MERIT SYSTEMS PROTECTION BOARD (MSPB) OR FILED

UNDER A UNION NEGOTIATED GRIEVANCE PROCEDURE?

 

NO

 

YES (If yes, complete 15b, 15c, and 15d below.)

 

 

 

 

 

15b.

MSPB

UNION NEGOTIATED GRIEVANCE

15c. DATE FILED (YYYYMMDD)

15d. MSPB OR UNION DOCKET NUMBER (If known)

16.LIST NAME(s) OF WITNESS (ES) AND BRIEFLY STATE WHAT INFORMATION WITNESS MAY CONTRIBUTE TO THE INVESTIGATION OF YOUR COMPLAINT.

17a. SIGNATURE OF COMPLAINANT

17b. DATE DA FORM 2590 SIGNED BY COMPLAINANT (YYYYMMDD)

DA FORM 2590, FEB 2004

PAGE 2 OF 3

APD V1.00

SECTION II - TO BE COMPLETED BY THE PROCESSING EEO OFFICER (EEOO)

18a. NAME OF COMPLAINANT

 

 

 

 

18b. SOCIAL SECURITY NUMBER

18c. DA DOCKET NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18d. TYPED/PRINTED NAME OF EEOO

 

 

 

 

18e. ADDRESS OF EEO OFFICE (Complete address to include office symbol)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18f. EEOO TELEPHONE NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18g. EEO OFFICE FAX NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18h. EEOO E-MAIL ADDRESS

 

 

 

 

18i. SIGNATURE OF EEOO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

19a. DATE COMPLAINT RECEIVED (YYYYMMDD)

 

 

19b. METHOD OF DELIVERY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IN PERSON

 

 

 

MAIL (postmark date)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

19c. DATE COMPLAINT DEEMED FILED

(YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FAX

 

 

 

OTHER

19d. DATE COMPLAINT ACCEPTED OR DISMISSED (YYYYMMDD)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20. IDENTIFY ISSUES IN BLOCK 10 BY PLACING AN A FOR ACCEPTED OR A D FOR DISMISSED IN APPLICABLE BOX(es)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APPOINTMENT/HIRE

 

 

 

EXAMINATION/TEST

 

 

 

REINSTATEMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ASSIGNMENT OF DUTIES

 

 

 

EVALUATION/APPRAISAL

 

 

 

REPRIMAND

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AWARDS

 

 

 

HARASSMENT (non-sexual)

 

 

 

RETIREMENT/CONSTRUCTIVE

 

 

 

 

 

 

 

DISCHARGE/RESIGNATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CONVERSION TO FULL TIME

 

 

 

HARASSMENT (sexual)

 

 

 

SUSPENSION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DETAIL

 

 

 

PAY/OVERTIME

 

 

 

TERMINATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DEMOTION

 

 

 

PROMOTION/NON-SELECTION

 

 

 

TIME AND ATTENDANCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DISCIPLINARY ACTION (other)

 

 

 

REASSIGNMENT-REQUEST DENIED

 

 

TRAINING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DUTY HOURS

 

 

 

REASSIGNMENT-DIRECTED

 

 

 

TERMS/CONDITIONS OF EMPLOYMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Specify)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

21. REMARKS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DA FORM 2590, FEB 2004

PAGE 3 OF 3

APD V1.00

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3. Completing NAME Last First Middle Initial, HOME ADDRESS, SOCIAL SECURITY NUMBER, HOME TELEPHONE NUMBER, DO YOU CURRENTLY WORK FOR THE, YES If yes complete a b and, NAME OF AGENCY WHERE CURRENTLY, a WORK TELEPHONE NUMBER, b EMPLOYERS ADDRESS Complete, PAY PLANSERIESGRADE, CURRENT JOB TITLE, REASON YOU BELIEVE YOU WERE, SECTION I COMPLAINT INFORMATION, RACE, and COLOR is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

Part # 3 of completing form da version print

4. To go onward, this next part involves completing a few fields. These comprise of EXPLAIN WHEN AND HOW YOU WERE, DA FORM FEB, REPLACES DA FORM R AUG WHICH IS, PAGE OF, and APD V, which are vital to carrying on with this particular form.

Guidelines on how to fill in form da version print step 4

5. This pdf has to be finished with this section. Further you'll find an extensive set of form fields that need to be filled in with appropriate information for your document submission to be complete: EXPLAIN WHEN AND HOW YOU WERE, a NAME OF ORGANIZATION WHERE, b ADDRESS OF ORGANIZATION WHERE, a HAVE YOU DISCUSSED THE ISSUEs IN, b NAME OF EEO COUNSELOR, c DATE OF INITIAL CONTACT WITH EEO, ELECTION OF REPRESENTATION, and d DATE NOTICE OF RIGHT TO FILE A.

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