The DA 2590 R form is a structured channel through which allegations of discrimination within the U.S. Army are formally addressed. Authorized under Public Law 92-261 and in line with the provisions of AR 690-600, this form embodies a commitment to the principles of fairness, equality, and rectitude in handling complaints arising from discrimination because of race, color, religion, sex, handicap, age, national origin, or reprisal. The form serves multiple purposes beyond the initial filing, including acting as a data source for generating summaries and analytical studies aimed at improving complaint processing and resolution efforts. Moreover, it facilitates responses to requests under the Freedom of Information Act and assists in adjudicating complaints or appeals. The disclosure of information through this form is voluntary, but incomplete submissions may result in the rejection of a complaint due to insufficient data. The document outlines specific steps for complainants, including filing deadlines post-final interview with an EEO counselor and the right to representation at all stages of the complaint process. Should grievances not be amicably settled, the form delineates the pathway for escalated resolution, ranging from investigation by the U.S. Army Civilian Appellate Review Agency, potential review by the Department of the Army Director of Equal Employment Opportunity, to hearings conducted by an EEOC-designated administrative judge. This ordered mechanism exemplifies the Army's protocol for ensuring that allegations of discrimination are given due diligence and systematically processed, providing a clear directive for complainants on how to articulate their grievances and seek rectification.
| Question | Answer |
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| Form Name | Form Da 2590 R |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | da 2590 have, eeoo name color printable, eeoo code interview, da 2590 00 printable |
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FORMAL COMPLAINT OF DISCRIMINATION |
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For use of this form, see AR |
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PRIVACY ACT STATEMENT (6 USC 552a) |
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Authority: |
Public Law |
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Principle Purpose: |
Formal filing of allegation of discrimination because of race, color, religion, sex, handicap, age, national origin or reprisal. |
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Routine Uses: |
This form and the information on this form may be used: (a) as a data source for complaint information for production of |
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summary descriptive statistics and analytical studies of complaints processing and resolution efforts and may also be used to |
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respond to general requests for information under the Freedom of Information Act; (b) to respond to requests from legitimate |
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outside individuals or agencies (e.g., Members of Congress, The White House, and the Equal Employment Opportunity |
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Commission (EEOC) regarding the status of the complaint or appeal; and (c) to adjudicate complaint or appeal. |
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Disclosure: |
Voluntary; however, failure to complete all appropriate portions of this form may lead to rejection of complaint on the basis of |
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inadequate data on which to determine if complaint is acceptable. |
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1. |
NAME OF COMPLAINANT (Last, First, Middle Initial) |
4. ADDRESS (Include City, State, and ZIP Code) |
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2.SSN
3b. |
HOME TELEPHONE NO. |
3a. |
WORK TELEPHONE NO. |
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5. |
ARE YOU BEING REPRESENTED? |
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5c. |
IF YES, NAME OF REPRESENTATIVE |
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a. Yes (Complete 5c) |
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b. No |
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6a. |
NAME OF ARMY ORGANIZATION YOU BELIEVE DISCRIMINATED |
6b. |
ADDRESS OF ALLEGED DISCRIMINATION ORGANIZATION (Include City, State, and |
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AGAINST YOU |
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ZIP Code) |
7.MAJOR ARMY COMMAND OF ACTIVITY YOU BELIEVE DISCRIMINATED AGAINST YOU
8.DATE ON WHICH MOST RECENT ALLEGED DISCRIMINATION OCCURRED
9.ARE YOU WORKING FOR THE FEDERAL GOVT.?
a. Yes (Complete items 10, 11 and 12)
b. No (Skip to item 13)
10.NAME OF AGENCY WHERE YOU ARE CURRENTLY EMPLOYED
11.ADDRESS OF YOUR CURRENT EMPLOYER (Include City, State, and ZIP Code)
12a. TITLE OF YOUR CURRENT JOB
12b. GRADE
13. Reason you believe you were discriminated against (Check Below).
a.RACE (State your Race)
b.COLOR (State your Color)
c.RELIGION (State your Religion)
d.NATIONAL ORIGIN (State Natl. Origin)
e. HANDICAP |
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Mental |
Physical |
f. |
SEX |
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Female |
Male |
g.AGE (Specify Age)
h.REPRISAL
14.I HAVE DISCUSSED MY COMPLAINT WITH AN EEO COUNSELOR (See Reverse)
a. Yes (Complete 14c) |
b. No |
14c. IF YES, NAME OF COUNSELOR
15.DATE OF FINAL INTERVIEW
16.EXPLAIN SPECIFICALLY HOW YOU WERE DISCRIMINATED AGAINST (That is, treated differently from other employees or applicants, because of your race,
color, religion, sex, national origin, age, mental or physical handicap, or reprisal.) (If your complaint involves more than one basis for your dissatisfaction, list and number each such allegation separately and furnish specific, factual information in support of each.) (Use additional sheets, if necessary.)
Allegation No. 1:
17.LIST IN ITEM 20 THE NAMES OF YOUR WITNESSES AND WHAT FACTUAL INFORMATION EACH WILL BE EXPECTED TO CONTRIBUTE THROUGH HIS/HER TESTIMONY TO THE INVESTIGATION OF YOUR COMPLAINT.
18.WHAT SPECIFIC CORRECTIVE ACTION DO YOU WANT TAKEN ON YOUR COMPLAINT? (If more than one allegation is being made, state overall corrective action desired and the specific corrective action desired for each separate allegations.)
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19.HAVE THE MATTERS LISTED IN ITEM 16 BEEN APPEALED TO THE MERIT SYSTEM PROTECTION BOARD OR FILED UNDER A NEGOTIATED GRIEVANCE PROCEDURE?
a. Yes (Explain in item 20)
b. No
20.REMARKS
21.SIGNATURE OF COMPLAINANT
22.DATE THIS COMPLAINT FORM WAS SIGNED BY THE COMPLAINANT (Month, day, year)
To be Completed by the Organization's EEOO
I certify that: (1) The complainant has reaffirmed this complaint in my presence and has stated that the facts contained therein are true to the best of his/her knowledge; (2) a determined effort at informal resolution of this complaint failed to produce a solution satisfactory to the complainant; and (3) local management in the appropriate change of command has been informed concerning the complaint and its submission in the above format.
23.SIGNATURE OF EEOO
24a. TYPED NAME AND TITLE OF EEOO
24b. ADDRESS OF EEOO
25.DATE COMPLAINT FILED WITH EEOO
26.TELEPHONE NO. OF EEOO PROCESSING COMPLAINT
The matter(s) giving rise to the complaint will be coded using one or more of the following codes:
CATEGORY |
CODE |
CATEGORY |
CODE |
CATEGORY |
CODE |
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Appointment |
(1) |
Training |
(9) |
Reprisal |
(17) |
Promotion |
(2) |
Time & Attendance |
(10) |
Pay, Including Overtime |
(18) |
Reassignment |
(3) |
Retirement |
(11) |
Conversion to Full Time/ |
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Separation/Termination |
(4) |
Assignment of Duties |
(12) |
Career Conditional |
(19) |
Suspension |
(5) |
Exam/Test |
(13) |
Reinstatement |
(20) |
Reprimand |
(6) |
Work Conditions |
(14) |
Awards |
(21) |
Evaluation/Appraisal |
(7) |
Harassment |
(15) |
And/Or Other (Specify) |
(22) |
Duty Hours |
(8) |
Sexual Harassment |
(16) |
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27.Enter Code(s) for Matter(s) Giving Rise to the Complaint
INFORMATION CONCERNING THE PROCESSING OF YOUR COMPLAINT OF DISCRIMINATION
This form will be used only if you, as an Army employee or as an applicant for Federal employment, think you have been treated unfairly because of your race, color, religion, sex, national origin, age, mental or physical handicap, or reprisal. If you have any questions concerning the completion of this form, you may contact the Equal Employment Opportunity Officer (EEOO) at your activity.
Your written, formal complaint must be filed within 15 calendar days of the date of your final interview with the EEO counselor. If the matter has not been resolved to your satisfaction within 21 calendar days of your first interview with the EEO counselor and the final counseling interview has not been completed within that time, you have a right to file a complaint at any time thereafter up to 15 days after the final interview. Your written formal complaint must be filed within 15 calendar days of the date of your final interview with the EEO counselor. This time limit may be extended if you can give a good reason for not submitting the complaint within the 15 calendar day limit.
You may have a representative at all stages of the processing of your complaint. You or your representative should personally file your complaint with the EEOO of your activity.
If your complaint is accepted, you will have an opportunity to talk with an investigator from the U.S. Army Civilian Appellate Review Agency and to give him or her all the facts you have which you believe will support your complaint. If your complaint is rejected, you will be advised in writing of the reason(s) and advised of the right to appeal. Upon completion of the investigation of your complaint, you will receive a copy of the investigator's report and an attempt will be made to resolve the complaint then.
If your complaint cannot be settled informally on the basis of the investigation, you may request a review of your record by the Department of the Army Director of Equal Employment Opportunity, or you may request a hearing at this stage. If a hearing is requested, it will be conducted by an administrative judge designated by the EEOC. The findings, analysis, and recommendations will be forwarded to the Director of EEO for decision. You will be advised by the Director of the decision and provided a copy of the case record.
If you are not satisfied with the Director's decision, you will have the right to appeal to the Office of Review and Appeals of the EEOC, P.O. Box 19848, Washington, D.C. 20036, within 20 calendar days after receipt of the decision.
Please be specific in stating the facts concerning your complaint in items 15 through 19.
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