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INCIDENT REPORT - DrewToma.com

HURT FEELINGS REPORT . To use this form, it must be physically placed in the hands of any Law Enforcement Officer DATA REQUIRED BY THE PRIVACY ACT OF 1974. AUTHORITY: S USC 301, Departmental Regulation, 10 USC 3013 and a log of other regulations too PRINCIPAL PURPOSE: To assist whiners in documenting hurt feelings ROUTINE USES: Whiners should use this form to seek sympathy from someone who cares DISCLOSURE: Disclosure is voluntary, however, repeated whining may lead to your file being stamped "candy ass" or some other appropriate term PART I - ADMINISTRATIVE DATA. A. WHINER'S NAME (Last, First, MI) B. WHINER'S AGE C. WHINER'S SEX D. DATE OF REPORT . E. TYPE OF WHINE USED F. NAME OF THE PERSON FILLING OUT THIS FORM. PART II - INCIDENT REPORT . A. DATE FEELINGS WERE HURT B. TIME OF HURTFULNESS C. LOCATION OF HURTFUL COMMENTS. D. WAS ANYONE SYMPATHETIC TO WHINER E. NAME OF PERSON WHO HURT YOUR PANSY ASS FEELINGS. (Please include paid witnesses).

authority: principal purpose: routine uses: disclosure: b. whiner's age c. whiner's sex d. date of report e. type of whine used f. name of the person filling out this form

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