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I certify that all of the statements made in this complaint
are true, complete, and correct to the best of my knowledge.
I understand that a false statement or concealment of a material
fact is a criminal offense (18 U.S.C. Â§ 1001).
I have provided my election concerning my filing status
in Part I of this form (Consent to Disclosure, Non-Consent
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and/or appropriately address my issue(s). I also understand
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I will be unable to request confirmation of receipt of this
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to the status of my complaint.
I understand that if the Inspector General determines
that the allegation(s) in my complaint cannot be investigated
without disclosing my identity on a need-to-know-basis to
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prevent further action from being taken on my complaint. I
further understand that even if I elect confidential status,
pursuant to Â§ 7(b) of the Inspector General Act of 1978,
as amended, and Â§ (d)(1) of the Library of Congress Inspector
General Act of 2005, as amended, my identity may be disclosed
if the Inspector General determines that such disclosure is