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Blank DOJ Inspector General voluntary interview warnings form, 2021

A blank Office of the Inspector General form advising an employee of warnings and assurances before a voluntary interview regarding job performance and security failures.Machine-written summary

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:

Job performance failure and security failure.

Job performance failure and security failure.

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

General Special Agent

Name of the Office of the Inspector

General Special Agent

Signature of Witness

Name of Witness

Date and Time

Place

OIG Form III-226/2 (05/03/21) Non-Custodial/Employee

EFTA00110193