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Do not include CUI, assessment evidence, system artifacts, screenshots, logs, or sensitive technical data in this form. If supporting documentation is required, DVS will provide secure upload instructions after intake.

Submitter Information

Company Legal Name*

Complainant Name

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Relationship to DVS*

Primary Contact Email*

Primary Contact Phone

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Engagement Information (Optional)

Engagement / Assessment ID

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Assessor(s) / Subcontractor(s) Named

Related Contract / SOW Reference

Complaint / Issue Summary (Required)

Allegation Category*

Impartiality / Conflict of Interest

Professionalism / Ethics

Quality / Consistency

Confidentiality / Evidence Handling

Marketing / Claims

Subcontractor Conduct

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Narrative Description*

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Supporting Documentation (Reference Only)

Document List*

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Attestation of Authenticity

The OSC attests that:

The information provided is accurate.
This is not a consulting request.
Assessment results cannot be changed through complaints or disputes.
No CUI will be submitted through this form or by email.
Records will be handled confidentially.

Authorized Representative Name*

Authorized Representative Title*

Electronic Signature*

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Date*