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:
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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 mc.
Ice o t e nspe eneral Employee's Signature
Speci Agent
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css Date
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Time Place
OIG Form 111-226/2 (04 23'07) Non-CustothaltEmplojee
SDNY_0001 8007
EFTA00035767