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PART I - ADMINISTRATIVE DATA PART II - …

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.

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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