EFTA00025225.pdf

Type

pdf

Source set

data-set-8

Original source

Extracted text

UNITED STATES DEPARTMENT OF JUSTICE 
Office of the Inspector General 
WARNINGS AND ASSURANCES TO EMPLOYEE REQUESTED 
TO PROVIDE INFORMATION ON A VOLUNTARY BASIS 
You are being asked to provide information as part of an investigation being conducted by the Office 
of the Inspector General. This investigation is being conducted pursuant to the Inspector General 
Act of 1978, as amended. 
This investigation pertains to: 
This is a voluntary interview. Accordingly, you do not have to answer questions. No disciplinary 
action will be taken against you if you choose not to answer questions. 
Any statement you furnish may be used as evidence in any future criminal proceedings or agency 
disciplinary proceeding, or both. 
WAIVER 
I understand the warnings and assurances stated above and I am willing to make a statement and 
answer questions. No promises or threats have been made to me and no pressure or coercion of 
any kind has been used against me. 
Signature of the Office of the Inspector 
Employee's Signature 
General Special Agent 
Name of the Office of the Inspector 
Employee's Name 
General Special Agent 
Signature of Witness 
Date and Time 
Name of Witness 
Place 
MG Form 111.226/2 (05/03/21) Non-Custodial/Employee 
EFTA00025225

Open in the interactive archive →