Download the form
The scope here is Department-wide. DD Form 2655 — DD Form 2655, Complaint of Discrimination in the Federal Government, June 2012 — exists to Complaint of Discrimination in the Federal Government, and it applies across the services rather than inside one. That is what the DD prefix encodes: joint issue, single edition, every branch and defense agency working from identical paper.
not stated is the prescribing publication and not stated the office responsible for the document. Deadlines belong to local implementing guidance, not to either of those, so a submission date is a question for the receiving office.
Current edition is not stated, carried as not stated. Check that against any copy you already hold before doing anything else — Department-level revisions land everywhere simultaneously, so a stale file is stale across the whole Department.
The set is PDF. Size: 3 pages, about 54 fields. Everything below refines that choice.
Fillable pdf is the default choice. Its boxes hold typed entries inside the document; the printable release is a static image of the same page with no interactive layer. Since DD forms routinely cross between services and agencies before they are filed, typed entries matter more here than on a form that stays inside one office.
What the form asks for
- For agency use.
- 1. Full name of complainant (last, first, middle initial).
- 2.a. Home telephone number (area code only).
- 2.a. Remainder of home telephone number.
- 2.b. Office telephone number (area code only).
- 2.b. Remainder of office telephone number.
- 3. Address (Street, city, state and ZIP Code).
- 4.a. Name of office that you believe discriminated against you.
- 4.b. Address of office (Street, city, state and ZIP Code).
- 4.c. Name and title of person(s) you believe discriminated against you, if you know.
- 5. Are you now working for the Federal government? Press space bar to mark X in first box if yes, second box if no.
- 5.a. Name of agency where you work.
- 5.b. Address of your agency (Street, city, state and ZIP code).
- 5.c. Title and grade of your job.
- 6. Election of representation. X first box if attorney, second if non-attorney, or third if no representation.
- a. Name of representative.
- b. Address (include Zip Code).
- c. Telephone (include area code).
- d. Fax (include area code).
- e. E-mail address.
- 7. Date on which most recent alleged discrimination took place: four digit year, two digit month, two digit day.
- 8. X why you believe you were discriminated against. a. Race.
- If checked, state your race.
- b. X if color.
Start by matching the printed date to not stated. Old blanks accumulate in shared folders for years. Because the Department reissues to all services in one action, nobody is still accepting the previous layout by local custom.
Work the printed sequence: header, body, signature block. The order is functional rather than decorative, since entries below frequently key to identifying data above them.
Mark inapplicable items N/A rather than leaving white space. Use the date format the form specifies. This matters more on Department forms than on service forms: the record may be reviewed by personnel outside your branch who share none of your office conventions.
Read the Privacy Act Statement before entering identifiers, not after. Four facts are in it: authority, purpose, routine uses, consequence of declining. Its placement ahead of the data fields is deliberate.
Signature comes after everything else and must be a signature: pen, or a credentialed digital signature via Common Access Card. Typing does not qualify. Add the date at the same moment.
Check before submitting. The recurring failures are edition mismatch, gaps in required boxes, unreadable scanned handwriting, wrong date format, and certification without signature or date. Field-level questions go to the printed instructions, then to not stated, which is authoritative.
Route it where not stated or local procedure directs, and keep a copy first. On a Department form the receiving office is frequently outside your own chain — another service, a defense agency, a joint command — which makes recovering a lost original slower than it would be internally.
Look up cross-referenced forms by series and number. DD numbering is unified across the Department, which removes the usual step of identifying which service issued the thing.
Do not read across from a service number. DA numbering is Army-specific under an Army proponent; DD numbering is Department-wide under not stated or an equivalent Department office. The sequences are unrelated, so identical digits in each identify two different documents. Read the prefix, not the digits.
Editions change when the prescribing directive is reissued, when the data collected changes, or when notice language is amended. None of that reaches you. Checking not stated at download is the entire defence, and it is cheaper than repeating a submission.
What is here is the blank form and a description of it. What is not here is legal guidance or any assurance about a particular filing — this page is not the issuing authority and does not speak for one. Those questions go to not stated, to your servicing administrative office, or to the authority identified in not stated.
Questions and answers
- What is DD Form 2655?
- DD Form 2655, Complaint of Discrimination in the Federal Government, June 2012
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?