DA Form 7279 "Equal Opportunity Complaint Form"

This version of the form is not currently in use and is provided for reference only.
Download this version of DA Form 7279 for the current year.

What Is DA Form 7279?

This is a military form that was released by the U.S. Department of the Army (DA) on September 1, 2010. The form, often mistakenly referred to as the DD Form 7279, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DA.

Form Details:

  • A 2-page document available for download in PDF;
  • The latest version available from the Army Publishing Directorate;
  • Editable, free, and easy to use;
  • Fill out the form in our online filing application.

Download an up-to-date fillable DA Form 7279 down below in PDF format or browse hundreds of other DA Forms stored in our online database.

ADVERTISEMENT
ADVERTISEMENT

Download DA Form 7279 "Equal Opportunity Complaint Form"

Download PDF

Fill PDF online

Rate (4.6 / 5) 56 votes
EQUAL OPPORTUNITY COMPLAINT FORM
For use of this form, see AR 600-20; the proponent agency is DCS, G-1.
PRIVACY ACT STATEMENT
AUTHORITY:
Title 10, USC Section 3013, Secretary of the Army: Army Regulation 600-20, Army Command Policy.
To provide a means for filing complaint based on discrimination due to race, color, religion, or national origin.
PRINCIPAL PURPOSE:
None
ROUTINE USES:
Voluntary; However, failure to provide all the requested information could lead to rejection of complaint for
DISCLOSURE:
inadequate data.
1. NAME
2. RANK
3. UNIT
4. RACE/ETHNIC GROUP
5. GENDER
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. 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.
(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. GRADE
8e. DATE (YYYYMMDD)
8f. AGENCY
8g. SIGNATURE
PREVIOUS EDITIONS ARE OBSOLETE.
DA FORM 7279, SEP 2010
Page 1 of 2
APD LC v1.00
EQUAL OPPORTUNITY COMPLAINT FORM
For use of this form, see AR 600-20; the proponent agency is DCS, G-1.
PRIVACY ACT STATEMENT
AUTHORITY:
Title 10, USC Section 3013, Secretary of the Army: Army Regulation 600-20, Army Command Policy.
To provide a means for filing complaint based on discrimination due to race, color, religion, or national origin.
PRINCIPAL PURPOSE:
None
ROUTINE USES:
Voluntary; However, failure to provide all the requested information could lead to rejection of complaint for
DISCLOSURE:
inadequate data.
1. NAME
2. RANK
3. UNIT
4. RACE/ETHNIC GROUP
5. GENDER
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. 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.
(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. GRADE
8e. DATE (YYYYMMDD)
8f. AGENCY
8g. SIGNATURE
PREVIOUS EDITIONS ARE OBSOLETE.
DA FORM 7279, SEP 2010
Page 1 of 2
APD LC 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 14 calendar days (3 weekend drill periods for
Reserve components) in which to initiate an investigation into the complaint, implement a plan to prevent reprisal, complete the
investigation, and inform the complainant of the results of that investigation. All formal complaints will be reported within 72 hours
to the first GCMCA in the chain of command.
9b. NAME
9c. GRADE
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: You have the right to appeal these actions to resolve your complaint. You will have
7 days (next weekend drill for Reserve components) to submit your appeal in writing. If you elect not to appeal, your case is
considered closed. If you decide to appeal, state the basis of, or grounds for, your appeal in the space below. I will refer your
appeal to the appellate authority, who will review your case and provide you feedback when that review is completed.
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. I have reviewed the complaint file, the investigative findings, and other information regarding this case. My findings are:
12e. SIGNATURE OF APPELLATE AUTHORITY
12f. DATE (YYYYMMDD)
12g. I acknowledge being counseled concerning the outcome of this appeal.
12h. SIGNATURE OF COMPLAINANT
12i. DATE (YYYYMMDD)
Page 2of 2
DA FORM 7279, SEP 2010
APD LC v1.00
Page of 2